A few years ago I read an article about a depressed and anxious psychotherapist who took a guided psilocybin trip. He emerged from the experience considerably calmer and more capable of functioning, with the insight: Show up and be open. His experience made a deep impression on me, and I took on that phrase as my own mantra which has since eased me through a number of potentially anxiety-producing situations. More recently, I read Michael Pollan’s book How to Change Your Mind, a comprehensive narrative about mind-altering drugs that includes a history of their development and use, as well as narratives of various people’s personal experiences, including his own. Pollan reports that a high percentage of the people who have taken psilocybin trips count them as among the most significant and transformative experiences of their lives, akin to the birth of a baby. Some talked about encountering people they knew—dead relatives, or their children, or even other versions of themselves—and working out new understandings about those relationships. Some talked about losing their egos and becoming part of the universe. People facing death emerged feeling stripped of their anxieties and their fear of death, and almost everyone felt they had come to a deeper realization about the importance of love. After a single trip many of them—most of them—felt significantly different for months and even years.  

Eager to experience such insight and transformation as I travel the path to death, I decided I wanted to take a trip myself.

Despite having come of age in the later 1960s and 70s, I have never been an avid drug taker. I  smoked a little marijuana back in college, but never have liked it much. I enjoyed some cocaine while working in film in New York in the 1980s. But unlike many in my generation, I have never tried a psychedelic drug. I was afraid that LSD or mushrooms would damage my brain irrevocably, and I was scared of having a “bad trip.” But now, with a terminal disease, I felt—feel—bolder. What do I have to lose?  I ran the idea by my doctors who gave me the go ahead, and I found myself a guide who was willing to come to my house with the proper dosages, guide me through a trip, and spend the night for a debriefing the next day. I couldn’t wait for my day of enlightenment.

The experience began with taking MDMA (commonly known as Ecstasy). The guide explained that this would relax me and open me up to the psilocybin. Having heard nothing but positive reports from friends who had taken Ecstasy, I was happy to begin that way. She prepared the drug which would be put into my feeding tube, and we settled in the light-filled living room in the early afternoon, the guide and I at opposite ends of the couch. She was a glowing New-Age-y woman with sensual lips, bright blue eyes, and traces of gold in her curly hair. She fit my image of a shaman.  She reviewed the contract we were entering which entailed honoring certain boundaries and not leaving the premises. I agreed.

Paul, my husband, used a syringe to insert the drug into my feeding tube. The guide, sitting on the floor now with an amplifier for her music and a mysterious bag of materials, invoked spirits from the North, South, East, and West, and we waited for the drug to take effect. She returned to the couch and asked me about my intentions for the trip and about my fears related to death and helplessness. I, typing on my text-to-voice device, tried to answer as honestly as I could. There is a way in which I welcome both helplessness and death as a relief from the pressures of life. This is perhaps an odd point of view, but completely true. The guide seemed to want me to feel grief, perhaps cry, but grief is not what I’ve been feeling. From the very beginning of my diagnosis, I have pictured myself in a rocking chair on the front porch, incapable of walking or talking, but watching the world go by and taking it all in with pleasure. The guide’s blue eyes were stunningly conversant as she assessed me for honesty.

I waited for the drug to enter my bloodstream, looking around the room, taking note of the sensations in all my body parts. I wanted to feel my heart opening, my body melting. Calming music was playing, and occasionally the guide drummed along with the beat and blew fragrant tobacco smoke from a pipe below and above my face. I savored being there in that light-bathed living room with the guide and Paul and Sandra, the filmmaker who was documenting this voyage. We were all on an adventure together, with no certain idea about the outcome. The guide continued to question me, and I answered as well as I could. After more than an hour during which I felt no effect from the drug, I looked at the guide and said, “Am I doing this right?” Everyone laughed and a second dose was administered. The guide was wisely cautious, in part due to my ALS, but I was eager to bring on an altered state as fully as possible.

More time went by, more chatting, more music and smoke. I was happy, but still in waiting mode, and keen on getting to part two if part one was not working. After a few hours during which I wasn’t aware of being altered, we decided to move on. A group hug ensued, and we moved to the bedroom where my psilocybin trip would begin.

We settled into our places, me on the bed propped up with pillows, the guide on the floor surrounded by her equipment, Paul beside me, Sandra in a chair. Everyone was on high alert, unsure how drug tripping would manifest itself in an ALS patient. I didn’t feel as scared as they seemed to feel. I was excited about losing my ego and exploring death. The guide reviewed another part of our contract: I was not allowed to die during the experience. This sounds amusing, but I understood, as I know that dying people have some say about the when the final moment of departure comes. I’ve seen that in my relatives as well as in patients when I was a Hospice volunteer. I promised the guide—and everyone present—that I would not die.

The dissolved mushrooms shot down my feeding tube looking like fecal matter. I hoped I wouldn’t vomit, but my stomach felt perfectly calm. The guide intoned more invocations as we once again waited for the drug to take effect.

At some point I closed my eyes, in part to achieve some privacy, and the pulsing swath of viridian on my eyelids told me I was getting high. I put on a face mask to keep me focused inward. Music was playing and orchestrating a sequence of dream-like images. First I was traveling through a kaleidoscope, vivid colors on all sides. I rose to the top of skyscrapers and wiggled between them. I found myself underground, beneath some kind of screen, not dead, but moving around. The music seemed to be situated in my head and it was orchestrating the images. I somersaulted over a purple carpet, soared to the ceiling of a cathedral, leaving my body behind. At some point there were angels, but I didn’t seem to be dead.

A second dose was administered (yes, I said I wanted it), and the guide blew more smoke in my face and stroked me with feathers. The images before my eyes continued, delighting me, surprising me. Occasionally I lifted the mask, but that ended my beautiful movie, so I didn’t do it often. At some point I got up to pee, and when I emerged from the bathroom, I noticed Paul’s feet were growing hair so I spent some time gazing at them. The bathroom itself felt like a palace of bright light, soft colors, and clean lines.

As things were winding down, the guide played a triumphant song while I gazed down at the inner workings of my skeletal hands. Then we danced to Motown, me and Paul and the guide boogying on the bedroom carpet, me crazily unstable but enjoying it nonetheless. There is little I love more than dancing, even when following the rhythm is hard. After that we stepped outside to view the brilliant pink-and-purple sunset, and the trip drew to a close.

Still dazed, still somewhat high, I sat on the bed and stared into space as the others went to the kitchen for something to eat. I was calm and happy. But I felt a kernel of disappointment too. I had not seen dead relatives and friends. I had not lost my ego. I had not witnessed death. I’d had fun, but it wasn’t transformative.

The next day I was deeply exhausted, too tired to make real sense of what had happened. But the following day I began to think about what the trip meant to me. I knew that the disappointment was real. But I was proud of myself for having taken the risk, for deciding to venture into the unknown. Despite not losing my ego or confronting death, I had had a communal experience I was glad to have had. The four of us were bonded throughout the day. We laughed and danced together and spoke honestly about death and disability. We had lived that day fully, sucking its marrow. And the guide left us with some mushrooms to push the experience further.

Expectations of certain outcomes, good or bad, are like smoke and mirrors that can distort an accurate perception of the passing moment. They play into our misplaced desire for perfection, or our certainty that we are doomed. I am thinking of my own desire, for example, to publish books that are widely noticed and widely read. To hope for this is fine, but to expect it is folly that sets me up for disappointment. It makes it hard to appreciate the good things that do happen with the books.

The same thing is true for my own death. I have imagined the scene as I want it to be, with loved ones assembled and holding my hands, harp music playing, a few final squeezes exchanged before I decide to let go. But what a silly Hollywood image that is. I know better, having worked with Hospice. Death is hard to do, and I sense that, in those final moments, I will not let go easily. I want to use this drug experience as a reminder to release expectations about everything: drug trips, publication, death. I don’t want the formulations in my head to obscure “reality.” Instead, I’d like to observe the precious passing moments as fully as I can: eyes and ears, nose and nerve endings all wide open.