Dr Jonathan Edwards (Suicide, Ketamine and Healing) - Episode 901

This episode is sponsored by Bubs Naturals, yet another company that I track down to bring on as a sponsor because I myself love their products. They are offering you, the audience of the Behind the Shield podcast, a 20% discount. But before we get to that, I do want to highlight a few of the products that I use myself. Firstly, collagen. I am about to turn 50 and so my hair, my skin, my nails, not really a big concern when I was younger, definitely a lot more of a concern now.

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And finally if you want to hear more about their products and Glenn's powerful story, listen to episode 558 with co-founder Sean Lake. This episode is sponsored by a company I've used for well over a decade and that is 511. I wore their uniforms back in Anaheim, California and have used their products ever since.

From their incredibly strong yet light footwear to their cut uniforms for both male and female responders, I found them hands down the best workwear in all the departments that I've worked for. Outside of the fire service, I use their luggage for everything and I travel a lot and they are also now sponsoring the 7X team as we embark around the world on the Human Performance project. We have Murph coming up in May and again I bought their plate carrier.

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My local store is here in Gainesville, Florida and I've been multiple times and the discounts you see online are applied also in the stores. So as I mentioned, 511 is offering you 15% off every purchase that you make but I do want to say more often than not they have an even deeper discount especially around holiday times. But if you use the code SHIELD15 you will get 15% off your order or in the stores every time you make a purchase.

If you want to hear more about 511, who they stand for and who works with them, listen to episode 580 of Behind the Shield podcast with 511 regional director Will Ayers. Welcome to the Behind the Shield podcast. As always my name is James Gearing and this week it is my absolute honor to welcome on the show anesthesiologist and the author of the revolutionary ketamine Dr. Jonathan Edwards.

Now in this conversation we discuss a host of topics from the suicide in his personal life that sent him down the journey of mental health, riding motocross, the origin story of ketamine, the application of ketamine in suicide ideation, ketamine in children, addiction, first responders, post-traumatic growth and so much more.

Now before we get to this incredibly powerful and important conversation as I say every week please just take a moment, go to whichever app you listen to this on, subscribe to the show, leave feedback and leave a rating. Every single five star rating truly does elevate this podcast therefore making it easier for others to find and this is a free library of over 900 episodes now.

So all I ask in return is that you help share these incredible men and women stories so I can get them to every single person on planet earth who needs to hear them. So with that being said I introduce to you Dr. Jonathan Edwards. Enjoy. Well Jonathan I want to start by saying firstly thank you to the IHMC team that's how you and I met initially and secondly to welcome you onto the Behind the Shield podcast today.

Wow thanks it's an honor thank you for having me it's a special one because it's something near and dear to my heart and something I've written a lot about so this is yep let's do it.

Absolutely well we exchanged books when we were there your book is phenomenal and we're going to get into that but clearly reading it you know you really are well versed in not only you know the mental health crisis in the country but also some of the people listening that are in uniform as well so I'm excited to get going. Yes yep. All right well very first question where on planet earth are we finding you today? Right now I'm in Las Vegas Nevada.

The place of you know endless gambling and you know the Super Bowl was just here and Formula One and right now the weather is actually exactly as it is in Florida for a minute you know until it becomes hot like much like Death Valley is. We're going to get into the whole mental health conversation but when I think of Vegas which I've never actually been to yet there are a lot of one what one would describe as unhealthy coping mechanisms in some of the business models of that city particularly.

What is your perspective of the overall mental health of that region versus maybe some of the other places you've visited? That's an excellent question and actually goes into the reason I've been kind of relocated you know. So yeah I practiced anesthesiology here for 20 years and as you know I mean it was the fastest growing city for decades and you know grew from like 500,000 to well over 2.5 million as it is today and I've seen it grown.

One of the things that got me into the whole question of what can we do about mental health and suicide was because of what I experienced in Las Vegas. Five of my colleagues all had children under the age of 18 who had committed suicide and that was just in my medical field right and that question always just burned at me. I was like how is this? These kids have everything anything you could imagine. I mean these are all well to do people. They're in the best schools.

One of the things that was obviously missing I think for those people is parents weren't at home as much but what lends into the question you asked is Vegas is a dangerous place. It's a 24 hour town. It is endless. If a kid goes off of the deep end here they can get lost in the underground here that does not stop and that's what's so dangerous I think about this place.

I mean there's Fremont Street and all these underground places that a kid could literally get into drugs everything for 24 hours and you won't find them and I know many police officers and firefighters who know of these systems and they work hard to protect their kids so anyway that's why we relocated to France for my daughter Charlotte her first grade. She did three years of internal and a full first year one year of first grader in France and then we had to make the decision.

Do we go back to Vegas or no we went back to Florida where her cousins are and family is even though it's smaller and it was harder for me to relocate and practice medicine but that in a nutshell is why we relocated from Vegas. That's not to say you can't raise a kid here and do well but personally after experiencing that and that all went into the book on the Revolutionary Academy and I read a lot about that but I think that's a good answer for what you're asking.

Well it's an interesting perspective because we were just talking about obesity and one of the things that I'd written and we shared the same frustration that both of our professions we lose so many people who are dying from disease just through simple inactivity and the wrong foods.

I've talked about this many times there's a lot of standing in ivory towers of some people when it comes to the obese population saying well if they just had discipline and they woke up and they ate salad and they ran just like me then they'd be fine.

The reality is a lot of us are products of our environment and I think this is an interesting perspective that you just brought when we're talking about the mental health crisis when we're talking about the opioid epidemic and some of these other factors that we're seeing in a country where we have and we're going to get into this obviously prohibition of addiction, so it's illegal to be an addict in this country.

In my opinion you've created an environment that sets people up for failure rather than success if they are born into some of these dynamics. Yeah, wow, eating every other just dying with every bite they take.

Just as we discussed I think a good way to open that is I've experienced many of the same things you guys do out on the field trying to do CPR on that obese individual knowing that their chances of survival on the operating table when that happens can be so small and it's frustrating because you can't produce the hemodynamics necessary to sustain life only because of what they've done to themselves before they got there.

How this country is so obese in the US is just mind boggling but it's not when you just consider the factors behind that and I'm sure you're well versed into that, the money and the profits and the motivations just like everything else is so strong behind what addicts people.

I mean just the fact that you have scientists who are paid to study the addiction of how addictive they can make their foods to go in the mouths of people every single day in a fast food restaurant is crazy and these people are paid hundreds of thousands or who knows to do this and some of them regret it. You can read about their regrets later in life but it's true.

The food is made to do its job and it has done its job at half the population being obese and then I'd love to hear your perspective on growing up in Europe, how it's different from what I've experienced in Europe and that'd be something I'd like to get into. Yeah well I'm gonna flip it on you and we'll go to France in just a second but just to throw it in.

Again environment, so had I grown up in inner city London or Manchester or something, my experience would probably be a little less healthy but again going to that environment piece, I grew up on a farm in rural England where we had vegetable gardens and an orchard and we slaughtered our own meat and so there was that very holistic element. I was so fortunate I fell into genetically a family that had that environment.

Conversely and I always talk about this, now you've got a kid that's in Brooklyn or wherever where their closest store might be a bodega, they've got a concrete landscape to play in.

Maybe if they're in inner city and they've got high rises everywhere, that's a very different environment to get a kid to be able to understand the importance of exercise and good nutrition and what foods even look like and how to prepare them and some households do it incredibly well despite their environment but the same with the mental health conversation. It's all very well saying these broken homes and rolling your eyes and all that stuff.

But if there's multi-generational trauma in inner city families where there's addiction and gang membership and other things, that is very different than the environment that I grew up in. Yeah, yeah, wow. Where to start with that one? I actually grew up on a, my uncle had a farm growing up so I was privileged to see kind of how it started from a young age.

But that being said, we moved to the, my own personal experience, we moved to the Southern California from Northern California and that was more desert so there wasn't much farming there. And yeah, we grew up near California where the gang problem was very prevalent. So we had a lot of crime and drugs and you know, I mean, by the age of 16, I had already, yeah, I'd already been held up with a gun.

I've already been, I don't know, beat up, almost killed by a gang and then I was actually held up with a machine gun against a wall for one hour. I mean, I look back and I just go, wow, I mean, how did I survive some of that stuff? And it wasn't like I was a bad kid. I was just going to, these were just house gatherings sometimes.

But I say all that because the, what else, you know, they're a product of their environment and there aren't the resources that you have when you grow up in the country and drugs are so prevalent and it's so easy for them to make their money and eat fast food every day and everybody around them is unhealthy and obese and that and it doesn't, yeah, it's just part of the problem.

And many of my life experiences right there is what helped shape me to want to care about this even, you know, to go into medicine and then to stem off from medicine and write about mental health and actually treat mental health. And I'd say where I'm going with this is like food treats mental health, you know, and if you have the wrong foods all the time, you're eating all the fried oils that have been in the fryers to cook the chicken for two weeks at a time and you get those chemicals.

I mean, it's no doubt you're going to have a mental disorder, you know, or at least have a good chance of it. And I think that's a lot of what we're seeing today, especially in America anyway, you know.

And then I recently met with Chris Palmer at the Metabolic Health Conference and many others who and Georgia Eads, for example, Dr. Eads, she's a psychiatrist who goes into the, you know, how you can actually help mental health disorders just through like cutting out the oils and the carbs and the processed foods. And, you know, I have several I have several directions I could go with that, but I'll leave it. I'll leave it at that for now.

Yeah, no, we'll definitely I'm sure we'll unpack some more as we go on. But you mentioned Northern California. So let's walk in, walk you from your early life forwards then. So tell me where you were born, but also tell me about your family dynamic, what your parents did, how many siblings? Yeah, I was born in San Jose, California. We lived there until I was seven. My father was a truck driver.

You know, just meager means my mom was a homemaker until we were until we were seven, I think we relocated when I was seven years old to Southern California. And we lived in the high deserts called the Hisparia, California, which is a Mojave Desert. Think of Joshua trees, you know, those Joshua Tree National Park, we were all near that. Yeah, we we were poor. Grew up on food stamps. I remember several times, you know, same foods every night, usually just what you know what my mom would cook.

And it wasn't necessarily I think back, it certainly wasn't the healthiest stuff. And yeah, the you know, we worked our way up. My mom became a real estate agent and a teacher. My dad started driving tractors and then he owned his own business and excavating. And then anyway, that's that's kind of how I how I grew up. And yeah, I turned out turned out to be I was the first kid out of almost 50 cousins to go to college. And that in that in itself was a big deal.

And then I let alone go to medical school. And and then the other thing, you know, growing up in the desert, I aspired to be a professional motocross racer. So I broke. So I had many, many run ins with the ambulances taking me to the hospital. So I guess that's how I got, you know, the notion that if I if motocross didn't work out, I was going to become a professional like a doctor or physical therapist or, you know, EMS or whatever.

And it just turned out I just I went for it and became a doctor. Yeah, yeah. When I was probably about 10, I remember coming home one day and my mother and father were in tears, which I didn't see my dad cry very much. And it turned out that his best friend, who actually was an MP, a member of parliament back then, had taken his own life. Now I know that there was a suicide early in your life that kind of impacted you.

Yeah. Yes. My grandfather, so there it was one of the first years we moved down to Southern California. You know, all my aunts and uncles were in the same place pretty much. And then my grandparents were there. You know, and it's interesting. My grandfather was born on a reservation. So it's good to preface it, preface the story with that. You know, he was very Indian. I mean, you know, born on a reservation in Tennessee, didn't talk much.

And I remember my mom and dad just saying, we got to go to grandma and grandpa's house. I'm only seven years old. And I was the only one who was who went. I remember getting there and just seeing everybody just crying at once. And I was, man, what's going on here? I still didn't know. And then I looked at the couch and then I saw a big blood stain and I was, man, what was that? Then I saw my grandmother just crying. And then they told me what had happened, that grandpa had passed away.

And I remember vividly looking at that couch and then seeing that, you know, his body in the other room. And yeah, it was a lot for a seven year old to take in that, you know, my grandfather had taken his own life and he had been put on oxygen. He had to survive on oxygen because of his years of smoking. And without warning, he just, yeah, he sat on that couch, put the shotgun to his chest and abruptly ended everything.

And it sent the family into a spiral in ways that, you know, I still think about it every day. You know, even if it's just a little bit, you still think about that every day. And it's, yeah, and I write, that's what I opened the book, The Revolutionary Ketamine with and I did that speak event, Ted Talk kind of thing. And I opened the story with that too. It was interesting. So yeah, it started young for me and I'm still going with it. Well, firstly, I mean, it's a tragic story.

I'm sorry to hear about that. Obviously it was a while ago now, but still, you know, a loss of human life. I mean, twofold, the cigarettes first and then, you know, the suicide itself.

I've had a few conversations with people and, you know, they're from the Native American background and one of the things that really kind of made me step back and think was, you know, we know in these uniform professions that the identity piece is a big part of mental health or ill health, depending on if we still see ourselves as the human being, the person who does this job, or we've kind of morphed into no, I am a firefighter. And then we transition out and it becomes a big struggle.

When you think about a tribe who was deliberately dismantled their identity, their language, you know, their practices, it really kind of makes you reflect on how horrendously detrimental that must have been to the mental health of some of our indigenous tribes. Yeah, the suicide rate is the highest period in indigenous tribes.

If you look at the Alaskan suicide rates, you look at the suicide rates on Indian reservations, they are among the highest percentages, even though they represent a small percentage of the population of the United States. When you look at how, you know, the suicide rates there, they're higher than just about anybody else. And part of it goes into their heritage.

As you can read about many old Indian stories, when a person thought they were no longer meant to be here on this earth, whatever that means, they define that, yeah, they would often just walk away from the tribe and wander into the forest or the desert and just let themselves die, you know, and just because they were going to pass on. And it was kind of understood, you know. There's several pieces of literature out there that are pretty easy to find and you'll understand.

I mean, there's a whole psychology behind it. I don't know if that had something to do with my grandfather. I mean, he was, you know, Americanized and all that kind of thing. But he's still very Indian. I don't know. I don't think he had a problem with Indian his life, though. I really don't.

That actually is an interesting perspective, because one of the real kind of awakenings that I had as I start interviewing all these people and a lot of whom have been there, I mean, I would say probably God, I should really count, but more than 50 percent of the guests I would think have been at that point of either about to take their own life and two cases actually went through their suicide attempt and survived. Kevin Hines jumping off the Golden Gate Bridge, Emma Benoit shooting herself.

Now she's an incredible advocate for mental health and just a beautiful soul. But what was glaring that you never heard mentioned and actually counted a lot of the prejudice that we had against that kind of thinking before was this feeling of being a burden. And that you could imagine is probably courageously, heroically what a lot of our Native American elders were doing. Like, I'm no longer contributing to the tribe. I'm going to remove myself from that.

But now you take a young person and anyone who's really not at that point yet and you add in all the unaddressed childhood trauma and sleep deprivation and organizational betrayal and all these little kind of pieces of the pie chart that we know now contribute. And now that miswired brain appears to trick the person that they are a burden. And what's so crazy about that is firstly, people with a healthy brain struggle to understand that.

But secondly, that now it flips it on his head because at that moment, their suicide is selfless and courageous, not cowardly as a fish. Now it's their truth. It's a distorted truth. But then when you tell someone, think about your kids, think about your wife at that moment, they are. And so it's this tragic distortion from a healthy mind reality to an unhealthy mind reality. But the more guilt and shame we add into the suicide conversation, the worse we're actually making it. Yeah, yeah.

You bring up a good point in the third chapter, I actually define what really triggers suicide. And like you said, being a burden is one of them. Being a burden, isolation, severe isolation, hopelessness, those horsemen of the apocalypse, all in a situation where you have means to end your life. That's by definition what the ingredients of a successful suicide contain. And we saw that during the pandemic, man. That's what the lockdowns were all about.

If somebody went to the hospital, they went alone and you didn't get to see them. Both parties were isolated to the max. And it's no wonder that many people just gave up their lives in the hospital. A lot of people didn't fight for their lives. You see people, you've seen it and I've seen it. You see people fighting for their lives. I saw less people fighting for their lives because they were isolated. Nobody could come see them.

So in a sense, I feel society killed those people or at least helped do so. And they had a chance to go out because they were isolated. They'd become a burden. They lost hope and their lethal means was being in a hospital. It's a different way to look at it. I can't help but think the people who had to respond to the houses and us who'd taken care of them in the hospital saw all those things. Well, you wrote a book on that, the pandemic itself. I would love to just unpack a couple of things.

Firstly, the event itself, the virus, when it was happening, like most things, I think 80% of us find ourselves when we're not being triggered and made anxious by governing bodies, we find ourselves somewhat in the middle. And the reality seemed to be that the virus was real, but it was also an opportunistic virus and your survivability depended also on your inherent health at that time.

So the takeaway should have been, in my opinion, let's do everything we can to give people autonomy, improve their own immune system, health, lose weight, move more, get day light, sleep better, for everyone will have a better outcome. So I had people on the show who have been terminated because of vaccine mandates, but I've also had ER physicians that were there and firefighters that were there where there were those hotspots where they were losing a lot of people in ICUs and ERs.

So firstly, talk to me from an anesthesiology perspective, what were you seeing medically through that? And also were there any commonalities in contributing factors or underlying diseases? Yeah, it was an interesting time because I mean, without a doubt, I saw people dying who shouldn't have died.

You know, I've run ICUs my whole career, you know, and I've seen even oncology wards, but the thing about early in the pandemic, I just remember seeing people who were just dying in their 50s that I was like, man, these people should be surviving this. And then, and that's why, you know, and that's why I actually, I took the vaccine at first, you know, just because I thought like, man, there's something I don't know here. And you know, you know, and I didn't do it after that.

But that was the biggest thing that struck me was that discrepancy that I wasn't used to seeing. And then we come to find out later, you know, a lot of it's because we didn't get them healthy or they weren't healthy to begin with, but we didn't pretreat the disease and no other disease known to man did we tell anybody, wait till you're blue at home and then come in. None. I mean, you got rheumatoid arthritis. You start diet and lifestyle. You start taking some anti-inflammatories.

You do the things, physical therapy, you do all these things before it gets worse. You have cancer. You know, you do all these things before it gets bad and kills you. This pneumonia, I mean, take antibiotics at home. I mean, we weren't even telling people to take vitamin D or antibiotics or steroids. I mean, that was the nuts part that I got pissed off about, you know, as I learned more and more and more about it and how we arrived there. You know, I hope we never arrive there again.

And I hope we... That's the other thing, you know, when I wrote about that first book on the suicide COVID-19 and ketamine, I actually talked a little bit about that, about, you know, get your brain healthy, get your mental health in order and get your own health in order. So if this ever comes again, you'll know what to do.

You'll have the medicines at home even, or know who to work with to give you options because so many people were left without any options except to get blue at home and go wait for ambulance to pick them up and go to the hospital alone. Oh, God. What about from the intubation side? It seemed like early practice was to intubate these patients and there seemed to be a kind of pivot where they were realizing that on a lot of these, it was actually detrimental to intubate early.

Oh, that's what killed a lot of people. I mean, there's no doubt. We were just, you were just ventilating dead space because it's not the pneumonia, the physiology of the pneumonia. And this is, admittedly, I'm not an expert in pulmonology, but I do.

But what I've learned enough from my pulmonary colleagues is that the pneumonia caused by COVID and even other viruses cause like almost a micro coagulation phenomena where the delivery of CO2 and oxygen is inhibited by coagulating the microvasculature going to the lungs. So we're not, in addition to all the mucus and blockages it did, it also did that.

So by ventilating, in many cases, depending on how severe it was, you could deliver all the oxygen you want, but you weren't optimizing the oxygenation of the body, which also got me interested in the inflammatory treatments like using, believe it or not, ketamine was used in a couple of trials to see if it would knock down the inflammation enough to improve these people on while they're intubated and sedated in the ICU. So it's, yeah, so I think we missed the boat there.

And obviously the market spoke for itself because the market on ventilators has decreased dramatically. And I think people realized that was the wrong way to go. And this whole craze behind the ventilators and then, you know, and I guess you can also get in, I mean, it's true, hospitals were incentivized to ventilate these patients at the tune of $30,000 per patient in most cases. And yeah, I mean, I witnessed that and there's no question about it.

The hospitals were subsidized to put patients on ventilators, you know, thinking it was the right thing to do, of course, because I was involved in some of that. And I remember thinking, but we didn't know what else to do early into it. And then it became obvious, you know, later on that ventilating the patients was probably the wrong thing to do in most cases.

One of the most infuriating things, and I've talked about this a lot, to me was addressing the underlying issues, like I said, the preexisting illnesses and just the overall ill health of a lot of people. And we had a captive audience for two plus years and an amazing opportunity to really educate the masses, to bolster some of the things that would start reversing the trend of obesity and the overweight that we have, I think it's 70%. Those two combined now, Americans are overweight or obese.

And sadly, every time I go back to England, I'm seeing it getting bigger there too. But there was this kind of, you know, chest beating about always saving lives or saving lives, but nothing changed. Schools are still serving processed food delivered by Cisco. There's still soda machines in all these schools. Local farmers aren't getting incentives to grow, you know, local healthy food, despite obviously seeing a huge bottleneck in our supply system.

So all the things that would actually truly be about lives, and just because COVID is done, doesn't mean that we're not still losing genocidal numbers in cancer and obesity and all the other things in the fentanyl crisis. So I feel that it was such a disservice and anyone that said it was about health is just lying. Anyone in those circles that were on the screens. As they say with a tree, the best time to plant one is 20 years ago. The second best time is now.

We get to reflect now if nothing else. What do we need to change having learned the lessons of those two or three years that we can apply today in 2024? I mean, that can go so many directions, but I mean, you know, I think if we just learn to eat at the dinner table, and I'm going to go back to where I learned in France, you know, I was a typical American before I went to France. It was always I was a different American in the sense you might appreciate.

I grew up in America and all I ever heard in America was like America is this. America is the best. America is the greatest country. There is nothing. No one else is better than us. You know, living somewhere else is not like America. And I just heard that all through my, you know, adolescence in high school. And I told myself one day, I said, you know, I'm going to go live in another country for one year and just see what that what it's really about.

And that and then when I got that chance after medical school, I moved to France and I got I luckily met the ambassador of science and he put me in Lyon, France. And I remember getting there and I didn't I knew some French but not not enough. And then so six months go by and I really learned French. But and at that time, I had had a French girlfriend and I started eating with them and I started being in the family. The father didn't speak English, so I have forced to speak French.

I was sitting at these three and four hour dinners. And then in the point of where I'm going at this, I learned to eat at the table. I learned what it meant. And and and many European cultures are like this. And even in England, I think they have this importance. But the importance of eating at the table, where so many problems are discussed, so many so many things that happen to you that are good or bad or whatever.

And just the way the food was prepared and most of its local, right, the importance of local food is huge, at least in France, where I was. And I'd have to say, as an American, I learned what that meant. And the power of that, if you wanted to change something about America, what if all Americans learn to eat at the table and really sat down and did it? What would that change? I could only imagine people would solve a lot of their problems. They'd care about more about what they ate.

They wouldn't be watching TV. They would have less fast food dinners. They would, you know, and I think nutrition is what you put in your mouth. You know, it's it's you can't live on supplements. And that's I don't know that I'm proud. I'm proud to be raised by the European system in that regard and bring it back to America. And so if you ask me, you know, what could what's one thing you could change? For me, that's that's it. That is a big thing.

Well, I couldn't agree with you more about the chess beat and being the greatest country in the world, because as I always say, firstly, we're not. And secondly, it's not a competition anyway. We do some things in this country that, you know, are better than anyone else in the world. But it's that rising tide lifts all ships and mentality have the humility to look around and look at the different countries. And I just heard about Japan and rope rescue in the fire service.

They went from almost having none at all to apparently being the absolute, you know, spear tip of the spear now when it comes to that, because they had humility to take the best of every other country and put it in their own super system. And I've had people on here, you know, the guys that the guy that helped decriminalize addiction in Portugal, prison governor from Norway, a teacher from Finland.

I mean, all these different places where in that area they are doing it better than the rest of us. And they're out there sharing their knowledge. You just have to have the humility to ask, hey, can you teach me how you did that? Yeah. Yeah, that's I'd say that's yeah, that's an important thing. You know, and I'm I, yeah, I pound that message everywhere I go. You know, people ask me why, you know, why, why did you go to Europe or this? And, you know, that that's why.

And that's why did it's also the reason I raised my daughter there, you know, until at least first grade. And, you know, and it's true when she's told to come to the dinner table, it means something else, you know, than say, than her cousins understand. It's it's pretty funny to watch. So yeah. Yeah. I mean, I grew up in a large family in a farm, like I said, and now, you know, I was a single dad for a while. And then, you know, my wife now, she had a little boys who have a blended family.

But it was really hard because they were very much, you know, throw the food down your throat and then go back into the room and then corral them in. You know, even tonight, we're doing a three course dinner with the boys just so we can spread out the food a little bit more and take more time. But the irony is this is what Americans did as well. All we're asking really is, hey, can we go back to 100 years ago? That would solve, in my opinion, 90 percent of our issues.

Yeah. I mean, it's thing if you started adding liver and, you know, high density foods, you know, there's everything, you know, the you know, the there's a reason you added my even my mom fed us liver once a week based on the traditions of the early 1900s, you know, because you had to avoid the diseases of rickets and, you know, measles and all that.

And by having, you know, high density nutrition is I think that's another if I had to say, you know, what's another thing besides eating at the table? It's the you know, the the the nutrition density of what we're actually giving ourselves is poor nowadays. You know, I mean, a chicken is not a chicken, right? It's raised in eight weeks. It's not it's not meant to be a matured in eight weeks.

That might be big enough, you know, for the hundred and forty million chickens that are killed each day just, you know, for the chicken industry, fast food industry, you know, but it takes twenty six to thirty six weeks. I actually went to Joe Salatin's farm. I had him on the show a couple of times. Yeah, I did a personal tour with him. You know, I just wanted my daughter to see how it's really supposed to be done.

And I have to say, you know, I know Joe from a couple of conferences and we've we've spoken and it was just great to see him in action. And then, yeah, it was interesting. One of his interns who gave us the tour, it was she'd been vegan, Colorado person, you know, for years. And then she got sick, you know, predicted predictably ill. And then she came to Salatin's farm and as an intern.

And she said she was able to overcome her fears of, you know, of consuming animal products through what she learned of Joel's farming practices and just the humility he brought into how to raise the animals and all that. And, you know, but anyway, my daughter got she her and my she personally, you know, espouse, you know, everything to my daughter at a young age. And that's what I was so happy about. You know, I was happy to pay the hundreds of dollars just to go see it.

And then, you know, it's you know, it I have to say, I can't say enough about what he's done in that whole movement. And, you know, and that's another point. I mean, if America went even 20 percent back to that, I think we'd see an improvement from the obesity, you know, crisis we're seeing, you know, now just just from that, you know. So it's a you know, it's a shout out to support the local people and farmers as much as you can.

And and then and I don't something else I'm sure you could relate to. It's the amount per capita that we actually invest in our food. America has one of the lowest. Dollar spent on our nutrition of what we serve at the dinner table compared to other countries. In fact, we're we spend less than half of what a typical French family puts to their food.

And I think, you know, most of Europe, I don't know about England, but I know France, Belgium and those countries in Switzerland put a lot more of their capital, their money they spent of what goes on the dinner table than we do as Americans. Yeah. Yeah. And you know, Joel has one phrase he said, you think food's expensive, try pricing cancer. It's a great way of putting it. You're going to pay one way or the other.

And I think as well, if if we got we eliminated all this unethical farming practices that allow some of these products to be so inexpensive, which is obviously also government subsidies that should be going to our holistic local farmers, you wouldn't then be eating meat three times a day, you know, which is so I mean, I'm just a big believer in just looking at the evolution of man, that's going to give you a pretty good indicator of what kinds of eating patterns should you do.

And it's obviously, you know, based on geography as well. But overall, there's no ancient, you know, element of mankind like ancient, that would have been able to catch enough meat to eat three times a day. I just don't believe that's the carnival.

I mean, each of their own, but the carnival, for example, to me, smacks against evolution a little bit, where all the effective diets seem to overlap, though, is the removal of processed food, whether you're vegan, whether you're carnival, whatever it is, that's the secret sauce.

But if you actually paid for good quality meat, you would find yourself eating meat less, not eliminating it, just eating it less because you're investing in and that meat would actually nurture you rather than poison you as we're getting at the moment. So, you know, going back again, a hundred years, there's no way in hell that our great grandparents were eating, you know, pounds and pounds of meat every day.

There was probably a lot of, you know, freshly made bread and, you know, fruits and vegetables. And then the meat would be kind of like the thing that you look forward to maybe in an evening meal. Yeah, yeah, you're eating twice a day, probably, you know, I mean, a lot of eggs and things like that. No, there's no doubt about that, I agree with that completely.

Yeah, there's no reality to anybody who hunts that you can just, you know, there were times you over consume food to gain weight to survive the winters where you could, you know, it's predictable you weren't going to have food. And my, you know, my grandma's from Poland and she told me about those times.

You know, she said there were times, yeah, they just, all they could make was, yeah, I think porridge and yeah, some of those foods you read about in the old classics, you know, there's a lot of truth to that stuff, right? Yeah, no, exactly. That's feast and famine. But then again, you know, there's this whole thing about ketosis and fasting. It's like, well, yeah, that's being a human back in the day. Sometimes you found a lot of food, sometimes you didn't.

It's not that, you know, again, mystical. Well, I want to go back to your timeline. So we left off, you're a young motocross competitor in the high desert. Walk me through how that young man finds himself in the world of medicine and ultimately anesthesia. The, so the, you know, all I ever wanted to do, I mean, I was one of those kids that was so determined to become a professional motocross racer since I was young, seven, eight years old that I mean, that's all I did every day.

I practiced hours a day, I worked out, you know, and I, school was very secondary for me. So I'd have, so that determination I put into motocross and it developed me as a human being, you know, just developed my mindset, you know, as, you know, as I'm sure you can relate. And so I went up, I took that path of motocross until I was 19 years old.

But I remember getting hurt so many times that, like I told you, if I always knew if motocross didn't work out, I was going to do school or, and as it turned out, I got severely injured. I think when I was 18, I busted my knee, they had to reconstruct it and from bone from my hip, tibial plateau fracture. And I remember my mom saying, well, you're out of high school now son. And if you want to stay in the house, you can pay rent or you can go to school.

And I was like, oh, I guess I have to go to junior college then. So I go off to junior college and, and I was like, you know, pissing the kick, this chemistry teacher named Dr. Chimichlis. I was pissing her off because I do okay on some tests and get Fs on others because I'd be traveling, you know, to motocross races, you know, across the country. And then, and one day when I come in with crutches, she just looked at me and just said, oh, what happened? I said, well, I broke my knee.

I got about four or five months now before I go and go back to motocross. And she says, oh, good. I've got you now, you little son of a bitch, and you're going to learn how to study. I was like, I had that just hit me from left field. She must've saw something in me. And anyway, she took me under her wing, taught me how to study. I stayed with her every night after class and I made up all the bad grades I did and eventually got A's.

But it helped me get A's in other classes and just the study habits. And if it wasn't for her, I have to say, I'm not sure I ever would have got to medicine. You know, I had the determination, but it's one thing to have the determination, but you got to be taught the proper skills. And she taught me the proper skills, bless her heart. And darned if I didn't make the Dean's List. And then that got me to UC Davis where I was a physiology major. And that was equally as hard as a stepping stone.

I got mediocre grades at first, but then I figured it out quickly. And just, I mean, we're talking studying until 11, 12, 1 a.m. at night, waking up at 6, getting back to the studying. And I just applied myself and didn't fool around and got back on the Dean's List in UC Davis. And that's what allowed me to get into medical school there in Eastern Virginia Medical School in Norfolk, Virginia. So it was, I attribute it to some lucky meetings, lucky chances in life.

But at the same time, I made those chances through my determination that I grew up, that I applied from racing motocross. I tell that story a lot because, you know, a lot of I think if you can learn the determination, you can apply it. Those are the tools you need to apply and succeed anywhere. Yeah. As you said, she obviously saw something in you. She seemed to be the right fit of teacher for you at that moment.

What were some of the study habits that allowed you to go from struggling to thriving? Specifically, she made me get last year's, the year's previous notes to her lectures. And she'd make me study those before class or before her lecture. So she would say, okay, I want you to study these last year's notes so you have an idea of what we're going to do. And then I would write my notes during the class.

And then she had me take the old set of last year's notes and the notes that I had had had in that class and put together a new set of notes. So I saw it one, two, and then three times. And when you do it that way, at least for me, it kind of branded it in your mind. And I almost didn't have, I could do that for all my classes and be efficient about it.

And then when the final exams or midterms came, all I had to do was go back to my perfect set of notes, review those, make sure I had those solid. And that system worked for me, I mean, even into medical school. So I'd have to, that was pretty, you know, I had no idea about doing that kind of stuff because I'd never been in AP classes. I mean, I kid you not, in high school, the best class I got in, the highest class I got into was geometry. And I missed like 40 days a year of high school.

They wanted to kick me out actually. A funny story is when I went to my 10 year reunion, one person had become a doctor and they said, oh yeah, we had one person go to medical school. And the guy sitting next to me goes, looks at somebody else and then he looks at the goes, what about Jonathan Edwards? Who's that? And then everybody looks at me and go, you became a doctor? Like I mean, people were just dumbfounded, you know, it was a funny moment in life anyway.

So beginning back, those were some of this, if I had to say anybody struggling with that, that's one way you do it, you know, get the old notes, put them together with the new, make a perfect set, practice perfect. And that's what she did to me. And I mean, that's not all, but it just also sparked my interest. I just like in calculus. I remember, I mean, it might be a geeky way to say it, but I salivated to go home and get my calculus homework done.

I mean, I just couldn't wait to see what was next. The adventure of calculus was just something that was so neat to me that for the first time in my life, I couldn't wait to go home and get the homework done and like see what it was going to become. It was just a neat adventure of life. And you know, I embraced it that way. And that's when I knew I'd wanted to keep going in academics. And it was just a, it was a neat, it's a neat story, but that's what happened to me. That's amazing.

It's funny with the reunion story. I had one of my friends on the show. It was supposed to be my very first interview, but we had technical issues. He ended up being, I think it was like a hundred and something, but he said to me of all the people in our school year, you were the last person I think I would thought would have become a firefighter. And I was like, Oh, thanks a lot. Because I was very small and kind of gangly when I was little. So it was funny hearing that. So a similar story.

All right. So now you find yourself in USF here in Florida in the world of anesthesia. So walk me through that specialty and then let's kind of start unpacking your exposure to ketamine and then how, you know, what, what you saw the other benefits of that drug would become. Yep. So I went, I mean, yeah, just, I told you, so I was in France. So at first I did internal medicine. Then I did, I did a year of that.

Then I did physical medicine and rehab, which is basically non-operative orthopedics and sports medicine. And then when, and then I went to France, did a year of neurology research, and then I had to decide on a full, you know, what my real special full-time specialty was going to be. And that was anesthesia. So I went to Tampa, Florida, USF, did three years there. And yeah, I did a lot of research, you know, a lot of trauma, lines.

I mean, with the cardiac transplants, liver transplants, I worked the burn units a lot. And so I bring up burn units because that's where I learned to use ketamine. And we, I mean, we use ketamine for everything there. Why did we use ketamine? Because you know, as you can imagine, people who got, as you know, very well, you get burned in the face, guess what? They become a difficult airway.

So you have to do everything to preserve the airway in the burn unit, especially, you know, especially people who have been burned, you know, with their mouths and you can't get their mouths open, you know, but you have to do dressing changes. So we use ketamine for all that. And so you became very good at sedating people with ketamine.

And then as I pointed out, I point out in the book that, you know, ketamine is still the most used anesthetic in the world because it's on the WHO essential list of medications because you can do anesthesia with it without the need of oxygen. In most cases, without the need of monitoring, you know, their blood pressure and oxygenation and heart rate is going to be fine.

If you're going to set a bone or do some stitches or sutures, I mean, you could even take an appendix out on ketamine if you had to, you know, it's just that kind of drug, you know, the unlike propofol, penethol, all the others that just are fentanyl that just completely take away your respiratory drive. And that's the, you know, and that's the power of it.

And so when I learned to use ketamine, I wasn't even aware in the, you know, the research that was being done at Yale about how it could stop suicide and mental health. It wasn't some years later that I became privy to that and just, it just, it clicked for me, you know, I was like, oh, wow, you know, so. You do, you know, one of the opening chapters of the book, you talk about the kind of metamorphosis of ketamine.

I love to hear that because it was a pretty, you know, interesting lineage that it's got. So talk to me about the kind of inception, you know, the highs, some of the lows, and then kind of where we are now. Yeah, yeah. The, you know, in the sixties, it was a, phencycloidine was the precursor to ketamine, which is angel dust. And they used it in the surgeries. It was a Wayne State University researcher who discovered it.

And it was discovered because the anesthesiologists were complaining about the postoperative delirium from phencycloidine. It was so bad that, I mean, people were just sent into, you know, trips that they needed, you know, I guess psychological help from that was that bad. So ketamine was the answer to that. Now ketamine was produced in the sixties and it was first tried on prisoners.

And then that's when they found that like, oh, ketamine not only produces dissociative anesthesia, but it preserves hemodynamics. So it became an ideal drug for, you know, to pentothal and methohexatol and some of the older sedatives that were once used. So fast forward into the Vietnam War and it became a buddy drug.

And that, it still wasn't FDA approved at that time, but when they saw that it could be used as a buddy drug, meaning your soldier who's your buddy and you're injured could give you this drug intramuscularly and get you to safety somehow, you know, whatever they did. I mean, you could even give a dose where you could technically walk with it, you know, if you had to with assistance anyway. Did that replace morphine that they used to carry? No, they used both, you know.

I think it became, yeah, I mean, as you know, in the Vietnam veterans morphine was still used a lot and I'm sure they used both in tandem. I don't know if they were privy to just using ketamine alone. I'm sure they found out very quickly that when they combined the two, they saw a decrease in respiratory rate. So I can only imagine that the doctors were saying, no, use the ketamine first, get them to safety, then give them the morphine. I'm sure that had to have happened.

So anyway, the FDA saw how effective a drug it was in the war. And so about the same time as when the FDA approved it for use in hospitals and immediately the anesthesiologist grabbed onto ketamine as a use in pediatrics, for example, you know, where the airway is so important to do sedations and then also to use as an operative room anesthetic because remember, paralytics were still in their infancy, really.

I mean, compared to what they are now, the paralytics used back then were long acting, you know, non-reversible in many cases and just caused a lot of problems, you know, sometimes allergic reactions, those kinds of things when you go back to atracurium and those ones. So ketamine really gained favor in the 70s and then other things became available like, you know, improved versions of penethol and then propofol came on the scene and those were better induction agents than ketamine were.

But the problem with ketamine is that it became a drug of abuse and so the story around ketamine became inundated through its abuse, which happened a lot in Russia, India, Asia, you know, in other places. So that was kind of the negative part and so ketamine use became less and less, as you would say, because there were other drugs to use.

And an interesting story, you know, like in Russia, for example, Vladimir Putin in the 80s or early 90s banned ketamine outright for animals and humans and Brigitte Bardot was an animal activist and she actually wrote Putin and said, at least give it to the animals, they need it, you know, for veterinary services and he did. He reversed it for animals but still prohibited for humans because of the abuse, you know.

So anyway, then other drugs of abuse became, you know, more prevalent like cocaine and heroin and all that kind of stuff. So ketamine kind of decreased in that sense, you know, from the abuse it was experiencing and other drugs took its place. And so ketamine has always been a good anesthetic, you know, but people didn't understand how it could like stop depression and suicide until...

The first studies actually were in England where they did it on patients who had bulimia, you know, and anorexia and they actually gave the drug to young kids and they found that it had a benefit. And these were, I think Manchester, if I recall, the studies are there but that was 1997-98. And then in 2000, the researchers, John Crystal and I believe Robert Berman and others said, okay, if it does that, let's see what it does to suicide and depression.

And they did this study called the Will to Live and the Will to Die. And these, you know, obviously suicide patients have the Will to Die. Do they have the Will to Live? And they found that ketamine put more patients than they ever could have thought in the Will to Live category. And so they, you know, they saw, they did the initial studies, they repeated them and found that, wow, this drug can stop suicide in its tracks. And that's where, you know, where we were, where we are today.

But let's back up. In the 70s, we already knew ketamine could stop depression if you read some of the studies or some of the, I should say, commentary articles about it. There were abuse clinics for phencycloidine and ketamine in the 70s. And one patient, I recall, and I wrote about this, I read about this in the book, she said, the doctor asked her, why aren't you taking your antidepressants? And she goes, oh, that's easy, doctor. Because ketamine works so much better.

It just doesn't last as long. So already we knew there were some hints that ketamine stopped depression in the 70s. And I guess one other piece of the puzzle of why we didn't know about or develop the potential for ketamine to stop suicide and depression is because of the ban on psychedelics, you know, that happened during the Vietnam War.

So in a sense, I mean, think about it, we lost, you know, if the 2000s were the first time, you know, we lost almost 50 years of psychedelic research to be able to discover and put into mainstream practice things like ketamine, ayahuasca, DMT, and MDMA, and all those other medications that can actually have an effect on suicide and depression till now. And that was thanks to people like, you know, not just Timothy Leary, but others. And the government's perception of what harm that was causing.

And they took a, yeah, I think they did a detriment to us all. And we could have been stopping suicide a lot longer, a lot, like in a lot, 20 years ago had this not happened. This is a conversation I've had with so many people now. It's been absolutely fascinating because it's seven years now this podcast has been going on and I've watched the shift with especially the law enforcement community. You know, I mean, these men and women were told these are the laws enforce it at the end.

So of course they're going to be the hardest kind of nuts to crack. And, you know, early on it was like, well, it is what it is. And then this is slow unraveling that I'm seeing. And even in this is really interesting in the special operations community were very tight lipped about, for example, opium in Afghanistan. And then about three or four years ago, they were like, let me tell you about the opium fields and how that's funding terrorism and all these things.

And so what we're seeing is again, the challenging the entire idea of, you know, the war on drugs air quote, and you look back even to the thirties with Harry Anslinger, the real inception of it, the reefer madness time, it was coming off the biggest failure, which was drug alcohol prohibition. The only reason we know Al Capone is because of alcohol prohibition. And then literally, I think it was a year later that failed. He's put in this position.

He himself is a screaming racist with a huge mental health problem himself. And he's trying to justify his position. And I think it was the version of the ATF back then. And so they start adding marijuana. And as you said, you know, psychedelics and it goes on and on and on. So fast forward to 2024, what is beautiful is now the very men and women that fought for this country were having to go overseas to find effective treatment for their trauma.

And now with the Navy SEAL community and especially with Ibogaine, you know, and some of these other communities, the mirror is being turned around and I think people are finally seeing the ridiculousness that is drug prohibition. Now, when you talk about that, people are like, oh, so you can just buy crack in the store.

No, we're talking about decriminalizing addiction, which then frees up all the law enforcement resources and legal resources to get the smugglers, the dealers and the criminals associated with that, you know, off the streets. But by taking these people who are struggling, some are in uniform, some are not.

But that's the irony is that the very officers that are arresting people, a lot of them have their own challenges and are using behind closed doors, taking them into the, you know, encircling them in the medical community compassionately and giving them addiction counseling, mental health counseling, of which that could include plant medicine, ketamine therapy, et cetera, and job creation, you're now taking people that are hurting and you're healing them,

which is actually the answer to addiction, because we know, I mean, we're almost at a hundred years now of drug prohibition, 80 something years. We know that was an epic failure. So taking that model that Portugal and some of these other countries have done so well, now ketamine, all these conversations that were so vilified before and now on the other side of the fence going, these are actually the things that are going to help you. Absolutely.

Yeah. Yeah, I think it's so ironic that you can buy lethal amounts of alcohol, you know, and we're allowed to judge how much we should take or not take. And then, you know, and Joe Rogan's brought this up quite a bit, you know, and I completely agree with him. I love how he puts it. You know, he goes out. I mean, you can buy any amount of alcohol you want and we're allowed to dose ourselves appropriately or inappropriately. And it doesn't matter what drug you make available to humans.

Humans are going to dose themselves appropriately and they're going to dose themselves inappropriately no matter what you do, whether you make it controlled, prescription, you know, prohibit its use or even, you know, it doesn't matter. You're always going to have that subset who abuse it and, you know, that's another problem. But you need to, that problem has to exist. You know, there's no utopia in the usage of these kind of drugs. And we can deal with that.

And if you let it fall naturally, it's still a small subset of the population in comparison to the large majority that it helps. You know, and so, yeah, I agree. To have people, you know, in jail solely for marijuana possession is just mind blowing to me nowadays.

You know, and I think, you know, at the same time, you know, I wrote about the whole Oregon experience and the revolutionary ketamine and, you know, I kind of, you know, and that, you know, they were actually legalizing everything and now they have, you know, they now they have an epidemic of fentanyl deaths like everywhere. So I think it's education, you know, it's not, it's not, it's not like throwing the arm of the law to control everything. It's like, how do we take these things sensibly?

How do they help? You know, how do they hurt? And those are the things, you know, you teach from a young age. You know, I don't know. I have to say I didn't learn all this in America because all I saw was, you know, my alcoholic father abusing alcohol. And then I have a good, you know, two interesting stories about that on my perception as an American. You know, I grew up with, you know, my father was an alcoholic and all that kind of stuff.

And you know, when he was off alcohol, what a, you know, awesome man he was. And then, you know, but on alcohol, on this never forget, you know, the terror he put through the family. And, you know, and I learned from that. And then I'll never forget, you know, I didn't go out often, but I remember I went to the, you know, the spring break tradition of a, of young Americans, oh, just go and drink as much as you can and that kind of thing. And I'll never forget waking up one day.

I was in the hotel room and, you know, and all, I woke up and I saw that beer can next to me and I was like, I want that. And I caught myself and I said, oh my gosh, that's, that's my path to destruction right there. And I just, I never, I, that, that I controlled myself ever since then. And then, so that's one experience I had as a young child that greatly, you know, etched into me that, you know, you cannot be, you cannot be addicted to alcohol.

And, and then the other thing is like when I was in France, all these kids were drinking, you know, they're, they're allowed to drink a little bit, right. And there's taste and be part of the family and all that kind of thing. So, so this idea of drinking a six pack or taking shots is completely foreign over there. Like it's not even a thing.

Like, like they look at Americans like, why, why wouldn't you enjoy that little drink you have, you know, that, that, you know, or, and, and, and the, this idea of drinking six beers and saying, oh, I downed a six pack is just absolutely mind blowing over there. Yet as an adolescent in America, that's how you're raised. And it, and it's, that's, I think we need to get over that.

You know, you, as you know, you go to Belgium, you know, you might have one beer because it's so heavy and tasteful that that's all you want. Or you go to France, you know, they make their little poivre or the little pear strong alcohols. Well, that's a digestif to be consumed only in small amounts, you know. And, and I, as you know, as a living in America so long, I, you have without doubt seen that difference. And, and I don't think many Americans appreciate that point.

No, it's, I've talked about that several times and, and the UK is obviously one click further towards America than France, for example. But I remember I did an exchange with a kind of family friend. I think I was about 12 and I was gone for a couple of weeks or something. And then, and then the family kind of drove all the way back to, to the UK and came to visit and everything too.

But before I was going to leave, I remember going in and buying my parents a bottle of wine from France and I walked out and went, Oh shit, I'm 12. How did I just buy this bottle of wine? But you know, that is the, is the difference. And then the UK, I grew up kind of with that French mentality where we had watered down wine, you know, when we were really young and then it became a glass of wine.

I remember one of the big things is on Christmas Eve and I was a little bit older and we're talking again, right when you're almost learning about, you know, Santa and kind of getting to that point where you're questioning it, I would still be excited. So now I'm in my, you know, 11, 12, whatever it was. And now I'm allowed to have a beer on Christmas Eve, you know, to quote unquote, help me sleep. But it wasn't demonized and don't get me wrong, there is alcohol abuse in England.

There's pubs in every town, village, and we have, you know, people that frequent it, that, you know, there is alcoholism there, but there isn't a demonization and that the age, you know, isn't as, yeah, my opinion, ridiculous as the U S because, you know, we can allow our children to go and get killed for their country at 18, but they can't drink till 21.

And so to me, I parallel to when I lived in Japan and what I saw with the Japanese culture was there was so much respect and hierarchy in Japanese culture. You don't question your, you know, you're the person above you and whatever rank that is. So there's a lot of repressed emotion, but then when they drink, they fucking drink, you know, I mean, you know, I mean, they are doing shots and of sake and all that stuff.

But, you know, and again, even with their, the anime and everything, it's a very peaceful culture now, but the violence of their history, I was talking to this to my son, cause he's a big anime fan. Their comics are extremely violent and extremely sexual. And again, it's that repression now in Japan, that's not so unhealthy, you know, but when you tell a, an American child, you can't drink till you're 21, you're drawing back that bow and then they hit whatever age they decide to start drinking.

They're not having an aperitif or enjoying a sherry or they're upside down with a hose pipe in their mouth while someone's pumping a keg, you know, or you know what I mean? And nowhere else in the world does that. And this is what America doesn't understand. I think a lot of it comes from again, demonization, that kind of Victorian mentality, same with sex in this country. You watch Rambo kill a million Viet Cong and that's fine on cable television, but they'll blur out a nipple of a woman.

It's the same thing to me. If you create stigma around it, you draw people to it. And so, you know, Amsterdam and some of those places, the actual Dutch people themselves, I'm pretty sure you'd find that there's not that many that are smoking till they're high as a kite, that it's probably just, yeah, well, it's, you know, it's what we do. It's how we unwind. Yep. Yeah, yeah, yeah. That's for it. Yeah. I hope people listening to this kind of explore that. That would be cool.

It's, it's, you can only get that if you, if you kind of like have, like you said, you have the humility just to like go see what other places do it, how they do it and not question it at first and then really get the education and then make your own judgments.

Well, I want to get to ketamine assisted psychotherapy, but before we go there, the drug itself, talk to me about the physiology, what is happening with that drug versus an SSRI or an opiate or some of the other, you know, drugs that are included in this conversation? Yeah, yeah. I mean, at its, I mean, to easy, to understand how ketamine works on the brain, it, it does several things. It works on the neurotransmitters. So these, you know, we exist on neurotransmitters.

Neurotransmitters are secreted from every neuron brain cell and that's what makes us human. And two of those neurotransmitters are called glutamate and GABA. So GABA stands for gamma, GABA are gamma aminobutyric acid. So one is kind of like, you know, the, if you will, the autonomic nervous system. It's kind of like the yin and the yang. The glutamate is the excitatory neurotransmitter. GABA is the inhibitory neurotransmitter.

And you got, so ketamine and other psychedelics will increase glutamate and we'll have a modulatory increase in GABA to that increase in glutamate. And that's what creates the loss of inhibition because the reason you and I are having this conversation in the sense we are having it now is because our brains are blocking out enormous amounts of sensory information. Enormous. I mean, the gates, you know, are just so close to all the sensory things that actually exist in our environment.

And so when you take a psychedelic and any of them, and they all work a little differently, you get this flood of sensory information and it's that flood that puts you in this different state of consciousness in a sense. And it's only at that sub anesthetic dose where this occurs. Because if you give too much ketamine, it becomes an anesthetic, right? And you know, and you black out and don't really recall anything just like most other anesthetics.

So at the sub anesthetic dose, which is about a half a milligram per kilogram intramuscular or intravenous, and we can go into that, you get this increase in neurotransmitters. And then that causes neuropathways to be created called neuroplasticity or gets you out of what's called the default mode network. And that's that, you know, easiest way to think about is the rut of depression that you find yourself in every single day.

So depression is defined by always being in the default mode network, meaning you can't stop thinking about those thoughts that send you into depression and eventually sometimes lead into suicide. And ketamine immediately puts you in your own mind and lets you safely look at those traumas that used to trigger you before.

So it actually helps you not have those triggers and say, I don't know, you know, let's, you know, take somebody from the Iraqi war who saw, you know, their soldiers die, their colleagues that they were in that tribe, and you know, and you know, and you know the power of that tribe. And, but now, and every time they thought about it before, they felt so, you know, completely guilty and completely just inhibited, and they would be in a sense shell shocked is where the term PTSD came from.

And imagine being able to go into a state of mind where you can examine that exact situation and be calm about it and be able to see the bigger picture of it that, you know, in a sense most people come out of a ketamine treatment knowing that they're just a speck of energy in the whole universe and the whole universe is way bigger than you and I ever could have imagined, you know, in our current reality. So that's that.

And then the other thing is I like to say is Lori Calabri, she's a ketamine researcher, she's done a lot of great research on suicide and ketamine and is that ketamine is fertilizer for the brain. I mean, it increases neuroplasticity and it increases the proteins of called mTOR, which is the, you know, the, it's a protein of rapamycin, you know, the mechanistic target of rapamycin is what it stands for.

And it's just, no, it's a protein and then along with BDNF, brain-derived neurotrophic factor and those two proteins are increased during most psychedelics. And that's what helps your brain respond to say like cognitive behavioral therapy or other types of therapy in the proper dose, in the proper environment. And that's what's so important about this is to distinguish it not as a drug of abuse but a drug of treatment.

And when used in those scenarios, that's why it can stop suicide in its tracks because it changes the hopelessness equation. You know, I like to say it's almost impossible to come out of a ketamine treatment and not have some change in your hope. And that's probably what stops people from committing suicide. It doesn't stop it permanently, by the way, but it at least stops it during that time. So say if you give it, it gives that person time to get help, the proper help.

And so there's so many things that go into it, but I hope that's a nice explanation in a nutshell of what ketamine does. No, it is. I want to circle back to something you said earlier because it was such a great point and I meant to kind of revisit, but the will to live versus the will to die.

This is something again, going back to that broken brain, I've used the analogy of, you know, if you and I went to the top of a 20 story building right now and we went walk towards the edge, there's that invisible hand pushing you away from the edge. You get that kind of pain shooting in your stomach and you know, the body is inherently saying no, no, no, no, no, bad edge bad, you know, roof good.

But then when you have this crisis, that hand goes behind you and it starts pushing you towards the wall, but towards the edge. This is the broken brain now. And so knowing that we are all inherently born with that will to live, that's literally, you know, our goal is to obviously grow ourselves and then reproduce and protect our offspring and feed them and clothe them and shelter them until they're able to go off and do their thing.

And then as you said, with the Native American example, there might be a point where you feel like my work here is done. Most of us, I think we'll probably just pass away in our sleep, but even so, you know, there's no more tragic example of the broken brain when it comes to suicide ideation than the young Florida law enforcement couple we had probably about eight months ago now.

The boyfriend took his own life first and then the girlfriend took her life, I think it was like a week later and they left behind an infant child. So that goes so far against our very, as you said, will to live and this I think really illustrates what we need to do to pull these men and women back from this crisis where they're not able to think for themselves.

They're so far gone, the reality is so distorted to believe that that little child was a burden, they were a burden to that very thing that relied on them. So ketamine, I want to get to the long-term benefits too, but with this, just pulling someone back from crisis back to, as you said, being able to have rational thought and then progress down a treatment plan is an essential part of the suicide conversation. Oh, yeah, yeah.

You know, I think things like ketamine and other psychedelics help you realize what the greater good is about. You know, we've gone so far away from, you know, whether you're religious or not, we all have, we all look up, we all like, what's the greater good? What are we trying to serve? How are you trying to better ourselves? Whether it's your family, whether it's your career, whether it's, you know, we're all trying to better something about the world we live in for ourselves and others.

And when you lose sight of that, that's, you know, in the right combination of isolation, hopelessness, burdens, you know, with the lethal means available, you know, in a period of intense vulnerability, that's where suicide happens. And I guess, you know, it becomes a philosophical question at that point, you know, of what good are you and how can you change that equation? And don't get it wrong, you can change that equation through therapy.

You know, most therapy changes that part of the equation. It takes somebody like kind of, you know, looking at you, squaring the eyes and going, you are good. You know, there is use for you in this world. And you have a lot of people to help and a lot of people who depend on you. And sometimes I think it's the case where you need things like psychedelics to help you with that.

You know, so I hope, you know, the question you're asking, that will to live and the will to die, you know, you've got to be in a space of intense vulnerability to pick that will to die. You know, it's kind of like, I'll give a story of a patient I talk about in the book. He, you know, he's an aerospace engineer. I mean, an extremely smart individual, you know, educated doctor and all that. He's in a bike crash, you know, gets a Lafort fracture basically and has a traumatic brain injury.

And never had a history of suicidal ideations before that. Six months later, he finds himself in the desert planning how to fall on his knife next to a tree in an exact manner. And why do I say that? Suicide is an engineering problem. People engineer their deaths and then people engineer their deaths to the point that not just any bridge will do. It has to be the Golden Gate Bridge. It can't be any other bridge.

So going back to this patient, it was his second attempt and he called me and he goes and he says, Dr. Edwards, do you have 30 minutes? And I said, sure. And so he explains the whole thing. And he'd been engineering this solution to his suicidal ideations for months. And this was the second time and he almost pulled it off. And that's when I said, okay, you know, we need to, you know, get you the right therapy.

But I said, this is clearly a case, you know, I think you're going to benefit from taking ketamine. And so we got it to him, a couple treatments in addition to the therapy and all that. And he was good. I mean, he kind of came back to his self, but I mean, it highlights the problem after traumatic brain injury.

Somebody who you never thought would ever want to take their lives is at risk of suicide, you know, and TBIs are, you know, prevalent in wars, sports, firefighting, you know, all that, right? And so we don't think about suicide in the terms of preexisting conditions sometimes, just, you know, you think it's all, you had a bad, you know, bad life traumas. It's not just that. It can also be brain injury.

And so for this gentleman to help him with the will to live, you know, it took a psychedelic and therapy, you know, because I'm telling you, he said his mind was hijacked. He described it as a complete hijacking of his senses. He walked through the desert furiously ready. And the only goal in his mind at that moment was to fall on the knife and end his life.

And he said it was like somebody had hijacked his brain and that's it, you know, and that's what I, when I did the, the Ted, the speak talk, speak event talk, it's a break off of Ted talks. And I like to say it's like a suicidal patient or, or a major depression is like walking through the fog with lead boots and not having any sense of the direction you're headed.

You know, so, so that's, that's where I think that gives a good description, you know, at least, you know, I like to, I always like to tell stories about that, to try to explain that concept and, you know, hopefully that, hopefully that, hopefully that does it for you. No, that's, that's great. Great. I think stories is the way that we understand these concepts and that's a great story to kind of bring us into that.

I just had the incredible good fortune to connect two firefighters, one, a good friend of mine with an ayahuasca retreat. The first one, he went in full bore and he's, you know, two very different cases. The one Tom, 30 plus year firefighter ended up walking from Key West to Tallahassee after like myself being so disgusted at how many, you know, of our brothers and sisters that we bury needlessly. Yeah, needless. And this ends up having a couple of strokes, you know, gets back in the gym.

I mean, just an amazing guy, but, you know, there's, there's multi layers of healing that needs to go on from, you know, regulating his hormones all the way through to his own mental health struggles. And there was sexual abuse early on as well. And his psychedelic experience, you know, he did a couple of ayahuasca because he was unpacking so much hearing, I'm going to get him back on, you know, when he's, he's fully on his feet to, to storytell his journey, but incredible.

But then I was connected. I was on another podcast and this is how the universe is so beautiful. The host after we recorded said, Hey, I've got a firefighter and she's a Canadian veteran, the host. So she said, I've got this firefighter. He's going through some stuff. You know, I don't really know where to, where to send him. Can you help? And so I sent him to the same guy, Sergio out on the show, the Agape church in outside Houston.

But what was interesting about his story is he said he tried ketamine and I asked him about it. I think I told you about this IHMC, but I said, well, you know, tell me about it because I've heard it seems to be a common denominator between the ones that are successful and the ones that aren't.

So this was very much, he went into, I don't know if it was one of those men's clinic type place, you know, the recharge or whatever it was, but anyway, he went in, they stuck an IV in his arm, they hung a bag of ketamine and then he walked out of the room and he just, that was it. Now I had, yes.

And so I had Katherine Walker on the show, who's a nurse anesthetist who actually ended up creating this series of clinics called a revitalist and they use, you know, ketamine therapy, so obviously same journey as you first in the OR and then carrying it over, but adding that psychotherapy elements. So you're on the ketamine, but as you said, now you need to start infusing the actual psychotherapy as well. So talk to me about those different roads.

You talked about someone in crisis and how that immediately can have an impact on suicide ideation. What are the applications of using ketamine whilst going through psychotherapy to dampen some of those kind of knee jerk psychological reflexes and allow you to actually start unpacking some of the things that have been bothering you? So it depends, you know, so there's two ways to go there. You know, you mentioned ketamine assisted psychotherapy and then there's ketamine with psychotherapy.

There are two different things. So we kind of already defined, you know, ketamine with psychotherapy means you're having psychotherapy with the psychiatrist or psychologist or therapist before and after the ketamine treatments. You know, the ketamine treatments are probably too deep to do any therapy during. So that's not done. The importance is that, like I said, ketamine is like fertilizer for the brain and that's when you're most susceptible to benefit from psychotherapy in most cases.

So that's ketamine with psychotherapy. So if a patient comes to me and they don't have a therapist, I work with a psychiatrist named Dr. Sam Zann and some others who will put you with the therapist right away. And that's important. I don't, you know, I always make sure that is done. I don't believe in just doing ketamine alone. And I've had many patients come, can I just do the ketamine and let it help? Yeah, not really. That's just not the way it is.

So now for ketamine assisted psychotherapy, that's, you're talking like a known anesthesiologist named Dr. Richard Wolfson. I may get his first name wrong. Dr. Wolfson will put you under a light dose of ketamine and at the same time, they will give you the smells of alcohol while you're lucent enough to recognize them. So you're not as deep under the sedation or psychedelic effect of ketamine. You can actually kind of talk and respond.

And I mean, these sessions are like three hours long, you know, versus 30 to 60 minutes. And so they're actually giving you suggestions and, you know, like they'll say, you know, here's the pugnant odor of alcohol and then boom, put the alcohol to you and let you smell it while you're, you know, you're just slightly under the influence of the psychedelic, in this case, ketamine. And that's the difference between like say for alcohol addiction using ketamine assisted psychotherapy.

And mind you, ketamine assisted psychotherapy can be used for alcohol addiction, cocaine addiction, heroin addiction. So you know, it's ironic that ketamine can be a drug of addiction, but at the same time, it can be a powerful therapy for addiction itself. So that's the difference between, you know, the two. And there's, yeah, and I mean, the success rate for how it can help people abstain.

And we're talking serious alcoholism here, you know, people, you know, who meet the definition of addiction where, you know, the drug alcohol has, you know, changed their lives and become, their masters, you know, their master has become alcohol and it disrupts their financial lives, their family lives, you know, everything about it. You know, they're no longer able to drink alcohol reliably in a controlled manner.

And so these are the people benefiting and it's had better percentages than something like Alcoholics Anonymous, you know. And a funny thing about Alcoholics Anonymous is that actually the guy who started it all wanted to use psychedelics in addition. But it was during the time, you know, when psychedelics had a bad name. And so he, you know, so the 12 step program all got, you know, done without psychedelics.

But if you read about the beginnings of it, the guy, I don't recall his name exactly, but you can read stories about how he used psychedelics himself. And then I think in those days it was LSD and all that kind of stuff. But yeah, that's, that would have been an interesting, you know, using the 12 step program along with psychedelics, you know, and therapy, I think would have been powerful. Yeah, Bill W, it was a good documentary on his story.

Actually, I can't remember if they talked about that in it, but it makes perfect sense. And I guess it's a 13 step program really. Step one is, you know, take ketamine or LSD or whatever it is and then progress through because all the other ones are unpacking, you know, your trauma. Basically they're addressing your shame and your guilt and relationships that you've broken down and, you know, looking in the mirror and understanding your addictions.

And so you do that alongside ketamine or MDMA or whatever your particular therapeutic of choice is. It does sound like a great combination because the 12 step program already has a great, you know, success rate compared to other things. So the couple two things that we know that work together, I mean, why not? Yeah. And I mean, you know, and, you know, suicide and first responders and firefighters, as we learned, you know, at the IHMC Blue Sky meeting, it just doesn't involve depression.

It never involves just mental, you know, burdens. There's always, you know, an element of abuse, whether it's, you know, drug abuse, alcohol abuse or, you know, other things. Every story we listen to, with the exception of one, I think, involves some sort of alcohol and drug abuse. Yeah, absolutely. Now, what was your perspective of, you know, the way that that was presented as far as the fire service?

Because, you know, being in that profession myself, I see resistance to some of the things that we've talked about today. I see immense resistance to the courage to actually address the work week, which is obviously evident in what I was passionate about in that meeting.

But, you know, knowing what the tools are, knowing the pillars of health, what is your perception of the fire service kind of culture towards what would actually move the needle in the mental health conversation in our profession? Oh, I was blown away. First thing I'll say about the Blue Sky IHMC thing, I didn't know Ken Ford was going to work us that hard. Kudos to him, though. We got a lot done, I think. But that being said, I think it's pretty obvious.

It kind of goes into many professions, whether it's doctors, firefighters, police, even soldiers. The stigma of saying you have a mental health issue is looked down upon automatically. That's obvious. And it's still present in most firefighting communities. You know, if you see a traumatic thing, well, here's a beer and welcome to the club. So you get that a lot. But the biggest thing is access to appropriate mental, even just talking about it, mental health care. It's like, it's just not there.

Nobody wants, there's a resistance to admitting there's a need for that. There's a resistance to, hey, maybe we should hire a full-time psychologist just for these things. Maybe we should have a, designate somebody who's thrilled about talking to their fellow firefighters and just anonymously having a gathering or drinks or just a meeting about the traumas they've experienced seeing a family of five all perish in a fire in front of them. It's like, who's doing the recourse?

And as you know, there's people who kind of handle that okay. I'm not going to say anybody ever handles it okay. But there are people who handle that better than others. And identifying those is the first step. But the mechanisms in first responders itself doesn't exist there.

It's starting, maybe the culture's starting to change, but man, saying that really bothers you and then having somebody to go to, as we discovered in the Blue Sky meeting, are the two big factors that are missing from almost all first responder communities. And then going a step further, which we can get into receiving mental health care, whether it be from therapy or psychedelics or anything really, is kind of you're on your own. And it's not a situation where you should be on your own.

So that's as an outsider from the firefighting community, though I've written about it and I know more than most, more firefighters lose their lives to suicide than in the line of duty. It's a fact year after year after year, even this year. I think that's what blows most people away when I start talking about the first responder crisis. They all have this idea of superheroes, oh, they put themselves in danger and they risk their lives and then they're blown away.

It's like, well, more of them take their own lives than die doing that. Absolutely. I think the other thing, and I touched on this when we were in the meeting, is at the front door as well. We were talking about the MMPI, the Minnesota multi-phasic personality. As the, that's it. That is your mental health evaluation to see if you're a good firefighter candidate or a bad one. That's it, black and white.

And having this realization of like, well, what if we shifted again to a compassionate lens where we took the money from the MMPI and the polygraph, both of which I think are ridiculous and instead gave five sessions of counseling to new recruits. And it could be simply just chewing the fat and having nothing really to say, or it might open the doors to some things that happened that ultimately sent you into a line of service.

Because so many of us, I think on the ACEs score, on average, we're six when they've done studies, same as prisoners, which is interesting. But there's usually a lot of unpacking to do, so what better way to really kind of reinforce our foundation than have that conversation on day one so that we can actually start working on that if it needs to happen, immediately have a relationship with a counselor, and then, that mental health conversation be a cultural element for every new hire.

And it wouldn't cost any more money because the money they're spending on the polygraph and the psych test, you just put into this instead. And like you said, hire a counselor to be on staff, a psychiatrist, a psychologist, and that's your go-to person now. So before anyone reaches crisis, they have some of these calls. It might not bother them. This is the problem we have is they do it immediately after, but it might be a month, a year, five years later that it starts to creep out.

But you have that person to go to and you've already laid the foundation of... Because my philosophy is this, we look at childhood trauma sometimes as like a victim element, I think, and please correct me if you think differently, but I think that trauma that has been addressed, that has been worked through becomes resilience. It becomes a superpower. And so there's that hope story. But if we just bury it down and hide it at the front door of a first responder profession, it's the opposite.

It becomes a cancer instead. Yes. Yeah, no, I can't... I would agree with that. How it grows and becomes a cancer is an interesting psychological thought experiment. You can go into Nietzsche and Jung and all those kinds of things. And I think what you just said is great about it becomes those traumas become a cancer to your soul so bad that they become those shadows that you don't want to look at. And then when you start looking at them, they take you straight down to hell.

That's straight from Nietzsche. Yeah, it's amazing. It's so pertinent. I want to hit one more area in this conversation, then go to your latest book and then some interesting totally different conversations. Just before we do, obviously the older we get, I would argue probably we're more apt to finally sit down and unpack, especially my age group, late 30s through to 50s-ish is seem to be when a lot of the responders really start struggling.

And at that point, you might have hit whatever critical mass, okay, I'm going to start unpacking it now. You talked about five of your medical professional friends losing children under the age of 18. That's a place where emotionally they might simply not be able to unpack. I just finished watching Leaving Neverland and these two boys that finally came out, it took them to be in their 30s before they were able to actually process and unpack and talk about what they did.

And that's a story I hope I'm going to be able to tell on here because that's a whole other can of worms. So I'm just going to put that to the side. Talk to me about ketamine and our youth that are struggling because I would imagine there was probably a very powerful element there because maybe they're not able to access some of the other areas that we as adults can.

The language you use to talk about trauma and death, the hardest thing for a kid ever is to lose a parent and they don't have the language developed yet to really talk about it. All they can just say is like, I feel sad, I feel this or that. They don't have the language to say that this person meant this to me and this is the effect it has on me now and that they're missing all that.

So that's part of like, and we're talking like eight, nine, 10, 12 years old kind of thing and you don't really come into your being of adolescence until later. So I think that's what's going on when we're young and experience trauma. And ketamine has been shown to help kids. So those research still needs to be done, but Laurie Calabrese has done some research on this, others.

And most of the data that we have on ketamine in adolescence is actually done in the adolescent cancer research where they get ketamine often. And ketamine helps kids in this sense, not all the time, but I think it's a powerful tool to consider.

And I think the most pertinent story is the one I wrote about in the adolescent chapter four there where in Las Vegas itself had during the pandemic in the year 2020, during the lockdowns when they were the worst, 18 school-aged children took their lives. Now the Nevada's always had a high adolescent suicide rate, one of the highest. And everybody was trying to say, oh, it's just the suicide rate we've always seen. It's not getting any better. And I vehemently disagree.

These were 18 school-aged children who didn't have a history, or at least most of the ones I was able to research, a history of mental, like bipolar, depression, or things like that. One kid who tried to commit suicide in his life in Vegas asked, and by the way, he looked up how to do it on his school-issued iPad, as many of these kids did. And when asked, he just goes, I don't have anything to look for. I don't have any friends. My dog just died. What else is there?

So from a kid's point of view, they were a burden. They are isolated. They lost hope. They're in an extreme moment of vulnerability. And they looked up a way of lethal means on their school-issued iPads. And to think about, 18 kids did this in one year in Clark County, Nevada, is just, what if one of their parents just could have recognized the signs? And you have to remember, that was a time you couldn't just take your kid into the doctor and get counseling.

If it was my kid, I would have been giving them something, ketamine, if I knew about it. And that was part of the genesis of this whole book. When I was talking to Gavin De Becker, who wrote the full word, and he was the one who gave me the initial push to write this book. He's a big advocate of ketamine therapy. And a little background on Gavin, he does the most elite protection, including the likes of Robert F. Kennedy right now, the Bezos. He has many people he does protection for.

You can look all this up online. And he's been on Joe Rogan, Tucker Carlson. But anyway, he's been a big mentor of mine for this. And it was a privilege to have him be able to write the forwards for my books now. So anyway, to go back to adolescence and ketamine, I mean, if you were a parent and you knew about this, the evidence is there to use ketamine now, not wait for the research. Absolutely. I appreciate that as well. I mean, this is such an important conversation.

As I mentioned, one of the two people that went through with their suicide attempt was 17. And so we're seeing it over and over and over again with our young men and women, especially after COVID. We all enjoyed it. Maybe not everyone enjoyed it. I didn't absolutely love my high school experience, but we had the opportunity to be in classrooms full of our friends and play during recess. And there was two years where that was stolen from our children. And then they were thrust back in.

And then also, the ones that graduated, you graduate into COVID, no jobs. And then you get ridiculed for being unemployed or on government handouts a year later when you didn't choose for the world to shut down either. So there's been some compounding areas. And then you look at the domestic abuse side from some of the people that I know in that field. And our teachers are more often than not the ones that are reporting abuse.

And now these children are locked in their homes, some of which they're locked in with predators or domestic abusers. So there's all these layers that we need to be thinking about to protect our children as well as the tools. And if ketamine is a tool, it should be part of the conversation. 100%. That's why I wrote the book, to be honest. Even if it just saves one life in that manner, I don't care. It's worth it.

Absolutely. Well, I want to go to, like I said, one more area and I'm going to hold up my notes so I don't butcher the name. Percutaneous hydrotomy. So I have no understanding or concept of this whatsoever. So this is your latest book. Talk to me about the issues of this helping with what it actually is. And then we'll talk about the book as well. So the title of the book is Stopping Pain and it's percutaneous hydrotomy. It's a revolutionary approach to beating pain and increasing function.

So it's one of those French things again that when I trained in France, I learned about it and then over the years I've known about it. Percutaneous hydrotomy is exactly what it sounds like. It's through the skin and it uses water, among other things. And as you may know, as a European, mesotherapy, meso is skin, therapy is to treat, is a huge thing in France and always has been. So all, and mesotherapy was first designed by Dr. Pasteur, Michel Pasteur, and to treat musculoskeletal problems.

One of his students was Bernard Ghez, Dr. Bernard Ghez. And he expanded upon the idea of using mesotherapy to treat musculoskeletal pains, arthritis, things like that, using what he coined is called percutaneous hydrotomy. And I get it's in a, it's kind of a complicated word and all that. But just, you're just basically using the subcutaneous tissue as a depot for physiologic saline, which is water contains salts, trace minerals, vitamins, anti-inflammatories, other medications.

Sometimes you might use a dilute dose of even corticosteroids, but very dilute. You might use amino acids. You use anti-inflammatories like Toradol, some others, and all, and local anesthetics. So what does that do? It creates, let's say you have a knee pain or back pain or shoulder pain, like frozen shoulder, it works wonderfully.

And you actually, you might put like even up to 50 milliliters or CCs or even, you know, maybe a couple hundred over the area of pain, and it blows up the subcutaneous tissue, which takes it no problem. And it slow releases over the localized lesion. And it's just, I mean, and it's not the end all, but it always helps pain and it always increases function. You know? And it just depends.

I mean, if you're bone on bone arthritis, it's going to help for a minute, you know, for some days, weeks, months, but eventually, you know, you're probably going to need that surgery. But depending where you are on the spectrum, like I've used it in many athletes like TJ Dillashaw, UFC fighter on his shoulder injuries and stuff, and it was part of the solution that allowed him to compete.

So, anyway, it's a, in a sense, it's a minimally invasive tool that uses a very tiny needle, the mesotherapy needle, and to place that combination of elements that allows the cells to heal in a sense, you know, and then you get in a can of worms. Like how can you prove that, you know, this therapy heals the cells? Well, and it depends if you go back to the, you know, are you trying to treat the pathogens? Are you trying to treat the terrain, the terrain as the French say?

And you know, are you trying to make the pasture healthier or are you trying to kill the microbes that attack the pasture? And so instead of using antibiotics, you know, you're using nutrients for the cells, which is water, amino acids, vitamins, minerals, in some cases, you know, you're using anti-inflammatories to just decrease these inflammatory neurotransmitters and other things like bradykinins, tumor necrosis factor, interleukins, all these kinds of things.

And then, what about the local anesthetics? Well, the local anesthetics are a great tool to break the pain cycle, you know. And you can even use ketamine in this sometimes. Like for neuropathic pain, you would add ketamine to this kind of treatment and it's already done. I mean, we do this in pain medicine all the time.

When you can break the pattern of pain and the patient can have like even a minute without that pain, it gives them hope that, wow, something just put me back into the place where I didn't feel this pain at one time. And that's, you know, in a sense, that breaks the psychological brain pattern of pain. And so there's, yeah, so there's a lot to it, you know. So that's in a nutshell, that's what percutaneous hydrotomy is. And it's, yeah. Brilliant. Well, I appreciate that.

So your latest book is on that. The one before, the revolutionary, excuse me, let me get, let me hold it if I get the right full title. The Revolutionary Ketamine, the safe drug that effectively treats depression and prevents suicide. So just give people listening, obviously, you've pulled some excerpts, some stories and some principles from there. What made you write the book and then tell people what they can expect behind, between the covers?

Yes. It's just that, that ketamine can be revolutionary. It might be, it might be that thing that saves you or your loved one from those grips of depression and suicide. It's something that can stop, ketamine is something that can stop suicide in its tracks. And in the book, you kind of, we go through the, you know, the genesis of how it became, you know, a research drug to a legitimate FDA approved medication to a party drug to something that can stop depression and suicide.

You know, and then we go, then there's chapters dedicated to who it affects. There's a whole chapter on first responders, police officers, firefighters, veterans. There's a whole chapter dedicated to adolescents, children. And then it goes into, well, why does ketamine work? Why does it break up the default mode network? What's really going on in a psychedelic treatment? And then at the near the end, how do you choose somebody to give you ketamine? What do you look for? What kind of clinics?

What kind of therapy? Where are the options? Who are some people who do it? How would you prepare for a ketamine treatment? All of that's in there. And, and the, and that, that's what the book was designed for. Well, like I said before, what was so good about it is it's very readable. You know, you infuse all these case studies and stories in with the science.

So by the time you come out the other end, you've learned what you want us to learn, but it threw what, you know, obviously I adore this forum, the art of storytelling. So it was, that's what I do. That's what I do on all my books. And then I should also back up and then stopping pain. There's a complete chapter of case reports and just how stories of people who've overcome their chronic pain through percutaneous hydrotomy type treatments.

And then, and that's, you know, I kind of, that's my style of writing books actually. So hopefully that's, hopefully people who read it, you know, will appreciate that. Thank you. And where can people find all your books? The on Amazon, they're all on Amazon. They're all on my website. And as you know, as you know, after reading your book, which is great by the way, I loved it. Thank you. That first, that first chapter was riveting.

Anybody, if you read, if you read the first chapter of your book, that's, that's a great read. I loved it. And then, you know, it sets the tone for the whole thing. Anyway, as you know, buying from the author themselves, from author copies gives us the most, you know, bang for our buck and book profits and keeps us doing what we're doing. So you can always buy it on my website, but you can easily find it on Amazon.

And also, as you know, please give reviews because, you know, it's just the, it's the Amazon monster. If you, you know, if you don't do that, the algorithm, things I don't understand, but I just know it's important. And I always ask people to please leave a review. It's a, takes, takes a few minutes. Absolutely. I need to leave one for your book. I'll do that today. All right. Well, then speaking of books, are there any books written by other people that you love to recommend?

It can be related to our discussion today or completely unrelated. Oh, you know, I think, you know, I, I put, I put a big plug in for Jordan Peterson's 12 rules of life. I think that can set people on the right, you know, cause a lot of people don't have access to good therapy, you know, and good therapy is expensive.

And I think he provides one way of being able to work with another therapist, but yet have a lot of ammunition when you go into the, you know, what it means to like get better, you know, or cleaning up your room, that kinds of things. Mark Madsen, who was interviewed on STEM talk, writes a book about glutamate. He was interviewed by Ken and Dawn and I, I think that is a wonderfully written book.

If you want to understand the neurotransmitters and why they are so important and how, why somebody could be possessed to kill themselves even. And in a sense, you can learn about what glutamate and how powerful it is. And then, you know, and then after that, I think learning how nutrition affects your brain. You know, there's many books on this, like, you know, oh man, they're so, you know, the EADS, the, what's the latest one called? You know, brain, brain power.

I'm blanking on his name, the, Chris, you'll know it. Anyway, I'll look it up. And anyway, any of those brain, Chris, power, Chris Palmer, he has got a great, great book, you know, on how to treat mental disease and Georgia EADS as well. So anyway, I think those are some of the books to wrap your head around and go from there. Beautiful.

So the next question, is there a person that you recommend to come on this podcast as a guest to speak to the first responders, military and associated professions of the world? Yes. I would say if you haven't had Dave Rabin, who was at the Blue Sky, I think he has a great handle on psychiatric treat, you know, the psychology and psychiatric treatment of first responders and ketamine and the different modes. And, you know, I think he would be, I think he would be a great resource.

And he's an interesting, just so interesting to talk to. I've been in touch with him since the Blue Sky. So I would definitely reach out to him. And if you need his contact, I have it. I think you do too. And yeah, he's one of the first ones to come up. And then there's, yeah, he's the first one who comes to mind on that, you know, on the wavelength of what we're talking about. Brilliant. Thank you. All right.

Well, then the very last question before we make sure where everyone can find you, what do you do to decompress? Hyperbaric chambers. So when I find myself in my hyperbaric chamber, I'm in a little cocoon and, you know, it takes effort to get in there and it takes effort to get out. So you know, you can't, I do, I have my own hyperbaric chamber at home and I, you know, I use it with some oxygen and that kind of thing.

And I can say when my brain just feels fried, you know, at the end of the day from whatever, doing a day of anesthesia or whatever, I get in that thing and I always feel better when I get out. And, but I have to say the power it affords me to decompress is really good, you know, and I can go in there, listen to a podcast or listen to some meditation music or just fall asleep.

And, you know, it's my own little space away from everything and I'm privileged enough to have one, you know, but there are ways. I think it's a great investment and I think it would be a great investment for any firefighter because when you guys are in the smoke, you know, as you know, oxygen, there's no better way to, you know, to rid yourself from all those carbon monoxide than using oxygen.

But I think in more ways than one, that kind of therapy lends itself to not only your mental health but also your physiological health, which if I had to tell you to have, if I could have you bring one more guest onto your podcast, it would be Dr. Scott Scherr, S-H-E-R-R. He's an internal medicine doctor who is one of the world's foremost experts on hyperbaric medicine. And I actually reviewed his book.

He's got an upcoming book and I helped review it and he could go into, it's his wheelhouse of how you could use HBOT applications, hyperbaric therapy applications to the betterment of all first responders out there and especially in firefighters. And I think, you know, I would be honored to put you guys together. So I think between Dave and Scott, that would be a great way forward for you to get, you know, I think they'd have some great conversations with you. Beautiful.

Yeah, let's make it happen for both of them if that's okay. Those are actionable items and I'll put that, I will make it happen. Thank you. One thing before we go to where people can find you, have you ever heard of the technology called Nucalm? I've heard of it, but I have to say I haven't looked much into it.

So it actually dates back like 35 years and the real cliff note story is there was apparently one of the most intelligent people we've ever had here in the US that dove into the neuroscience of frequencies that the brain is at during different emotional states. And then after 20 years or whatever it took him to figure that out, he was like, huh, well can we manipulate the brain to get into those emotional states?

I came across Jim Poole, who's the CEO, the actual scientist, actually passed away the founder of this, but what it used to be was a $6,000 large machine that would sit in Napa, Napa, excuse me, not a cabbage, in NASA. I was thinking DARPA as well, but the Navy SEALs and some of the NFL teams and you'd put on headphones and an eye mask and in 20 minutes you get the equivalent of like a two hour nap and then there's all these kind of down regulation or up regulation settings.

Well about a year and a half ago, the smartphone technology got so advanced that they were able to put this on an app. And so when you're in your hyperbaric chamber, for example, I'm literally going to go and do it now. And so I'm a real kind of self-experimenter. I'm not a big proponent of wearables and biohacks and all the kind of terms that we have now, but I can tell you hand on my heart that this technology works. Like when you do the down regulation ones, it is absolutely incredible.

And then the focus one I use when I'm writing. So I know what you're talking about. Yeah. The whole 740 Hertz thing and all that. Yeah. There's a, yeah. And I know what the, I know of the technology and research you're talking about. I didn't just didn't connect it to the new com. Yeah. Yeah. Yeah. I highly recommend looking into that because I mean that if you added that to your hyperbaric, now you're doubling down on the impact there. Absolutely. Nice. All right.

Well then I'm sure people listening are fascinated. We talked about where they can find your books, where are the best places to find you online, websites and social media. Just my website, Jonathan Edwards MD.com. Most of it's there. I try to maintain some presence on Instagram, Twitter and all that at John Edwards MD spelled with an H. You know, it's hard to keep up on the whole social media stuff, you know. And then I'm searchable.

My email's on my website and you know, so I'm not, you know, I try to respond to just about, you know, if I get a nice, you know, a neat message or something like that, I always try to respond if I can. And yeah, so I'm easy to find and you know, look it up. Brilliant. So you don't respond to like sup and then a winky face. Yeah, I know. All right. Well, it has been such an incredible conversation.

Obviously, like I said, you know, hopefully the results of what we did together will be published to the Fire Service when the time is right. It's not quite there yet, but you know, we exchanged books. We had a, you know, a short chat then, but it's been an incredible conversation and all the different kind of arms to your work are so invaluable for the people listening. So I want to thank you so much for being so generous with your time and coming on the Behind the Shield podcast today.

James, thanks for having me. This is incredible and I'm sure, you know, we have things in store for our future to work together and let's keep doing it.