For nearly 40 years, I have practiced medicine as a physician and anesthesiologist. Throughout my career, I have guided thousands of patients through anesthesia—carefully creating a temporary state of unconsciousness and then, just as carefully, helping them return to consciousness.
In anesthesia, we call this process emergence.
I never imagined that one of my most profound experiences of emergence would involve an anesthetic itself.
That anesthetic is ketamine.
Ketamine has been safely used as an anesthetic for decades. More recently, it has also emerged as an important tool in the treatment of certain mental health conditions, including treatment-resistant depression and PTSD. What makes this especially meaningful to me is that I know these struggles not only as a physician, but also from personal experience.
The wounds we carry
All of us experience trauma in some form. Some experiences are what we might call “little t” traumas; others are profound, life-altering events. Regardless of how we label them, painful experiences can leave lasting emotional wounds.
Healing does not necessarily mean erasing those experiences. The scars may remain. But the wounds can heal.
When painful experiences overwhelm us, we often develop ways of protecting ourselves. We suppress emotions. We avoid difficult feelings. We disconnect from painful memories. We tell ourselves that we are fine and keep moving forward.
For me, that became my coping mechanism.
I learned to suppress my emotions, avoid uncomfortable feelings, and, in a sense, anesthetize myself emotionally.
At first, this worked. Avoidance can be remarkably effective in the short term. But what protects us temporarily can eventually prevent us from healing.
Learning about emergence
During my residency in anesthesiology, one of my senior attendings taught me something that stayed with me: every patient who goes under anesthesia must eventually emerge.
In the controlled environment of the operating room, we can temporarily eliminate pain, support vital functions, and carefully maintain the body’s equilibrium. But anesthesia is not the destination. Eventually, the patient must awaken. The body must resume its normal functions, and the process of reconnecting with the world begins.
Years later, I began to understand that this was true emotionally as well.
I had spent a great deal of my life trying not to feel certain things. Eventually, that strategy stopped working. Depression began to take hold, and I gradually came to recognize something that was difficult for me to admit:
I needed help.
I worked with several psychiatrists and therapists and tried numerous medications, but I continued to struggle. Then I learned about ketamine.
I remember approaching treatment with something close to hopelessness and the thought, What do I have to lose?
That brought me to Keta Medical Center.
Opening the door
My treatment with esketamine, also known as Spravato, together with the support of the medical and therapy team at Keta Medical Center, became an important part of my journey.
The experience did not simply make everything better overnight. Rather, it seemed to loosen some of the defenses I had built over the years. Things that had once felt too difficult to approach became a little more accessible.
And that is where the real work began.
Working with a therapist I trusted, I began exploring some of the experiences and emotions I had spent years avoiding. Through that process, it became increasingly clear that unresolved trauma and symptoms of PTSD were contributing to my depression.
Recognizing that connection changed the direction of my treatment.
Going where I had been afraid to go
Because trauma can become deeply embedded in the way we experience memories and emotions, another therapeutic approach was recommended: EMDR, or Eye Movement Desensitization and Reprocessing.
EMDR is a psychotherapy approach designed to help people process distressing memories so that those experiences can become less emotionally overwhelming and less likely to feel as though they are happening all over again.
For me, the combination of ketamine treatment and trauma-focused therapy created an opportunity to approach difficult material differently.
Ketamine did not do the work for me.
It helped open the door. Therapy helped me walk through it.
That distinction is important.
Exploring painful experiences requires patience, trust, and a sense of safety. I have approached that darker territory slowly and cautiously, surrounded by people I trust and in an environment where I feel supported.
Emerging
My journey is still unfolding.
I don’t think healing means that we forget what happened to us. And I don’t believe that becoming whole requires pretending that our painful experiences never occurred.
Instead, I am learning to acknowledge what happened without allowing it to control me.
We can all carry scars but we don’t have to live inside the wound.
After nearly four decades of putting patients to sleep and helping them awaken, I have come to appreciate the meaning of emergence in a completely different way.
Sometimes, we spend years anesthetizing ourselves from the things that hurt.
And sometimes, healing begins when we finally allow ourselves to wake up.
As Peter Gabriel sings in Digging in the Dirt, there is something powerful about being willing to explore and find the places where we’ve been hurt. For me, that journey has meant having the courage to look beneath the surface—to acknowledge what I had buried, to understand how it shaped me, and to begin finding a way forward.
