TrueLife - Innovation and Compassion: The Sam Mandel Story

Episode Date: October 6, 2023

One on One Video Call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_US🚨🚨Curious about the future of psychedelics? Imagine if Alan Watts started a secret society with Ram Dass and Hunter S. Thompson… now open the door. Use Promocode TRUELIFE for Get 25% off monthly or 30% off the annual plan For the first yearhttps://www.district216.com/Introducing Sam Mandel, a force of compassion and innovation in the realm of mental health care. As the Co-founder and Chief Executive Officer of Ketamine Clinics Los Angeles (KCLA), Sam’s journey is one of profound dedication to healing. From the early days of volunteering at a teen-to-teen suicide prevention hotline to managing one of the world’s foremost Ketamine Infusion Therapy clinics, Sam has channeled his lifelong advocacy into transforming lives.In his role, he orchestrates the symphony of operations that make KCLA a beacon of success and ethical care. From nurturing patient satisfaction to pioneering cutting-edge technologies, Sam is a relentless advocate for best practices in mental health.Join us as we delve into the mind and heart of Sam Mandel, a mental health advocate, entrepreneur, actor, and rapper who’s changing the way we approach mental health care and giving voice to the underserved. Welcome to a journey of compassion and transformation.https://ketamineclinics.com/sam-mandel-ceo/ One on One Video call W/George https://tidycal.com/georgepmonty/60-minute-meetingSupport the show:https://www.paypal.me/Truelifepodcast?locale.x=en_USCheck out our YouTube:https://youtube.com/playlist?list=PLPzfOaFtA1hF8UhnuvOQnTgKcIYPI9Ni9&si=Jgg9ATGwzhzdmjkg

Darkness struck, a gut-punched theft, Sun ripped away, her health bereft. I roar at the void. This ain't just fate, a cosmic scam I spit my hate. The games rigged tight, shadows deal, blood on their hands, I'll never kneel. Yet in the rage, a crack ignites, occulted sparks cut through the nights. The scars my key, hermetic and stark. To see, to rise, I hunt in the dark. fumbling, furious through ruins

maze, lights my war cry Born from the blaze. The poem is Angels with Rifles. The track, I Am Sorrow, I Am Lust by Kodak Serafini, check out the entire song at the end of the cast. Ladies and gentlemen, welcome back to the True Life podcast. I hope everybody's having a beautiful day.

I hope the sun is shining, the birds are singing, the wind is at your back. it's such a beautiful time to be alive. There's so much going on right now. And for those of us paying attention, the world is changing right in front of our eyes. I got an incredible show for you today. The one and only Sam Mendel. And I'm excited to introduce you to him today because he's truly extraordinary. He's a person who's all about making mental health care, compassionate, innovative, and accessible. His journey began with a big heart and a passion for helping others. Starting as a volunteer on a teen-to-teen suicide prevention hotline, he already

knew the importance of lending a helping hand during tough times. Today, Sam wears multiple hats as the co-founder and CEO of ketamine clinics, Los Angeles, KCLA. He's like the conductor of a symphony, ensuring that KCLA not only excels, but does so with a strong ethical compass. He's not just about business. He's about doing what's right. He knows that mental health is often misunderstood, and he's on a mission to change that. He believes that society has a moral duty to break down the stigma around mental health, and he's leading by example. Innovation is his middle name. Sam brings cutting-edge technology and therapies into the mix, always keeping the moral side of things front and center. But what truly sets him apart is his dedication to making mental health care fair and

inclusive. He's all about ensuring that everyone, especially those who've been underserved, gets the help they need. It's all part of his mission to do right by people. So ladies and gentlemen, get ready for an engaging chat as we dive into the world of Sam Mandel, a mental health. A mental health advocate with a big heart, a knack for innovation, and a whole lot of approachability. Sam, thank you so much for being here today. How's your day going so far? It's good. And thank you for me, George. And that was quite a wonderfully generous introduction. And I really appreciate that. And thank you for that. Yeah. Well, it's true. Briefly, you and I were speaking before we went live about what a transformative time it is. And it sounds to me, some of the things you're doing echo

the transformation that happened in your life. Maybe you can give us a little bit of a background, How we go from the teen side to mental health to where you are today. Yeah, I have quite an eclectic background. I did volunteer for a teen line when I was 12 years old, which is a teen-to-teen suicide prevention line. And a couple days a week after school, I would take calls from kids in crisis. And that was my first, I guess, more formal exposure

to working around mental health and supporting people in crisis. I found it really gratifying. And I was from a young age, the one in my friend group who people went to when they, you know, needed to talk about things that they didn't really feel like they could talk with adults or other kids about, more, you know, deeper conversations, heavier material. I just always felt more comfortable in, in that realm than most people. And still today, I, I prefer that to small talk. You know, I can, I can talk to somebody about their really dark demons and what's really going on for them in a way that I think is

It's just, it doesn't scare me. And some people get really awkward or uncomfortable in those conversations. They don't know what to do or how to support people. And I'm always learning every day how I can be better in managing my own mental health and how I can be better in supporting those around me. And it is something that I feel I'm good at and I am passionate about. And my friends and family have suffered a lot. A lot of people are close to me from mental health conditions, from addiction,

people we've lost to suicide. including as recently as this year. So it continues to be really front and center in my world. And I've had plenty of my own challenges and struggles over the years as well. And I feel like the current health care system as a whole has really failed us, at least in the United States. And I think there's a lot of evidence to support that. And especially where mental health is concerned. And obviously with the pandemic and everything that's been going on economically in the last couple of years, that has finally started to get more attention, which is great. More people can relate to it. And there's an increased focus on it, which is great. And we have a long, long way to go

before I think we're at a place that is more imbalance with the demand and the need and the amount of suffering and the amount of actual solution and relief that's happening. It's really well put. And I'm often not only reminded of, but inspired by and sort of curious about those people who have found themselves getting close to that burning ember of death, be it through someone you love that may have attempted something or be it through a real loved one that you stood there and hold their hand as they were passing or you were close to them. Sometimes being so close to that flame leaves a residue on you. And it sounds to me like that residue causes you to think in a deep way that can be frightening, but can also be the light that helps you guide other people. It sounds like that's something that you've been close to. Absolutely.

I mean, you know, in many cases, I mean, with my grandfather, I literally held his hand as he was, you know, taking his last breaths. He was in the hospital for a procedure. He had a pacemaker that had some sort of a malfunction, had to have a kind of, you got toxic, had to have more emergency surgery. He was 92. It was a hard surgery on him. He didn't really fully recover from that.

And after a couple of days in the hospital, trying to kind of bring him back, it became very clear to me. I was alone with him in the hospital. And I called my family and I said, we got to get him home because his wishes were to pass it in his home. And I could just tell it was, it was, you know, eminent. And got him in an ambulance that same day, took him home, you know, kind of transitioned him into hospice and sat with him. And people, you know, said their goodbyes and spent some time with him.

And when everyone left, I stayed with him. And yeah, he passed that early that morning. And yeah, it's, you know, death is tough. It's hard. Lost is hard. Grief is hard. It's a part of life that a lot of us don't like to look at. or have to experience.

Yeah. It's, you know, there's a lot of reasons why people seek out different kinds of therapy. Some people are dealing with a past issue. Some people are worried about the future. Some people are worried about the end of life or maybe something that happened to them. It seems to me there's probably a myriad of different people

that are coming and seeking some of the treatment you're providing. Is that accurate? Oh, absolutely. Yeah, with what you're talking about, there's a quote I love that's pretty popular that, you know, depression is worrying about the past and anxiety is worrying about the future. Love it. And obviously they're both much more complex conditions or symptoms, if you want to think of them that way, than that.

But that's a nice, simple way of kind of thinking about it. I think there's a lot of truth in that. We see a wide variety of patients. So at ketamine clinics, Los Angeles, we specialize in IV infusions of ketamine for mental health. We can dive more later into all that. as much as you want, kind of what it is, how it works, et cetera. But we've been doing this work for a decade. We were one of the first ketamine clinics in the country, co-founded it with my father, Dr. Stephen Mandel. And it was just the two of us for a long time. And now we have a team of 16,

fantastic staff and a 5,000 square foot facility that's really, you know, serene and purpose-built for this treatment. And there's a lot of nuance to the way we do things being that we've been wholly committed to this one treatment. So the whole business has really been built around delivering this one thing in the best possible way. In the last year, year and a half, we've expanded to include psychiatric medication management, just more conventional management of people's prescriptions, and TMS, or transcranial magnetic stimulation, which is also relatively newer and less understood treatment by the general public, but is actually very good for mental health as well.

So we've been expanding to be more comprehensive with that. We've gone to network with almost a dozen insurance network. in California to increase access to care, help people to be able to afford these treatments. And there's a lot more I could say about all that. But back to your comment, yes, we see a wide variety of patients, primarily for depression, anxiety, PTSD, suicidal thinking. We do also see some other mood disorders and like OCD or other various types of depression, like postpartum depression, bipolar depression, addiction.

etc. But the primaries are the depression, PTSD, anxiety, and suicidal thinking. And ketamine is fantastic. I believe it's the best treatment that's currently legally available today in the United States for those conditions. And but the reasons why people come to us, I mean, we have people, you know, they've had a lifetime of struggle with these conditions, someone going through a life event, whether it's a loss of a loved one, you know, a divorce or a huge shift in their life that's really hard for them that they get stuck in anxiety or depression around that and they're unable to kind of get out of it. You know, when that type of thing, it's obviously quite normal and natural and healthy

to have, you know, emotional challenges around big and difficult life events. And when those challenges start to persist for four, six, eight weeks and onward, and they're really disruptive to your life. and you're not getting past them, that's when it's time to start to think about reaching out for help. Not to say that you can't reach out for help on the very first day. And I think asking for help is great and getting support from friends and family and really digging into your wellness and your routine to help support you through a challenging time is great.

And when it's persisting and the things you're trying to do aren't really working for you, then when I say ask for help, I'm really meaning like professional help. It's a time to start to think about am I in need of more, whether that be therapy, medication, ketamine infusions, or something else, definitely. It's such an interesting topic, and it seems to me that we're presented with so many avenues of changing the way we can model reality these days. I'm curious, maybe you can tell me what it looks like. Is there talk therapy and integration that comes with the ketamine therapy?

Are there psychologists? Or what is like a full treatment if somebody comes in? say for PTSD. Do you sit down and talk with him with your team first and figure out what it is? If you didn't give me a rundown of what it looks like for a new patient. Yeah, there's a lot of different models and approaches within this field of different ways of using ketamine, different routes of administration. You know, either that be intravenous or IV or intramuscular injections, which is I.M.,

sublingual lozenges that dissolve under the tongue. You know, there's a lot of companies now that are selling it through the internet for home use, unsupervised, don't recommend that. Don't think it's particularly, you know, safe or effective for, you know, most of the time. There's some risks there. You know, we specialize in IV because that's what 90 plus percent of the research is on. And we have the in-clinic model where you're supervised the entire time and you're safe and we can, you know, monitor you. And we have a really wonderful, diverse team of clinicians. So we have two in-house psychiatrists. We have a psychiatric nurse practitioner. We have a physician assistant. We have a team of four RNs,

registered nurses. And then we have an entire admin team as well to support them. And then, of course, my father is an anesthesiologist and he has a master's degree in psychology. We have a really diverse and large team to give people individualized attention and for them to benefit from the knowledge and experience of multiple skill sets. That's pretty unusual in this field. And in any, really any health care system, quite frankly. But within this field, especially, it's often one doctor and maybe an assistant who are providing treatments. So we have this collaborative care model and we feel like that's a big part of why we get better results. So in Academy Clinic's Los Angeles, patients will inquire, we explain things to them over the phone, what it is, how it

works, get some information about them, see if it's a good fit. Then they have a consultation with a provider, or usually over the phone, to go a little more in-depth into their treatment history. That provider will also have one with their other treating position. If they're currently seeing a psychiatrist or a therapist or even just their internist, because actually the majority of antidepressant medications are actually written by internists. And so, you know, a lot of people prescribed medicines that way. So we'll verify what they've shared with us and get a little more background on the patient, sometimes review their medical records from their current or former providers, then if it seems like it's a good fit, they'll be invited to come in for infusions.

They do some paperwork. They come back. We make them comfortable, do a brief physical exam, and then also talk with them further about the experience, what you expect, answer any kind of last questions. And then the infusion itself is an hour long. They recline in a really nice recliner. It's completely flat. We give them pillows, blankets, noise-canceling headphones, relaxing music.

We have many thousands of hours of relaxing music with no lyrics that they can choose from and some that's been shown to have some good benefits in this kind of a setting. And then we also have Spotify premium and they can pick playlists or bring in their own or, you know, whatever they might like. Definitely recommend relaxing music without lyrics. That's important. music is extremely influential on the journey. And so you don't want any kind of messaging, kind of guiding you there outside of your own internal work that you're doing.

And you don't want like death metal or something that's negative and aggravating. You know, it's fine. That's not really my jam, but if you like that music, fine. But in this setting, you really want to be relaxed and feel good and peaceful. So, yeah, then we use hospital-grade monitoring equipment. We monitor them for vitals with their pulse, oxygen, saturation, blood pressure, EKG. Our nursing team has eyes and ears on them at all times. After we've started the IV, we run the medicine, and it is a gradual infusion.

It's not a shot or an IV push where you get it all at once. It's a, or as technically would be referred to as Ebola. So we don't do that. We do an infusion, so it's an hour-long, slow, continuous, steady drip. That's one of the keys to the therapeutic. benefits of ketamine is a slow and steady continuous infusion. And we monitor them, make sure they're comfortable, and we will adjust the dosing as needed during the infusion, which is something that we're quite good at and where a little bit of the art meets the science. So helping to identify, does this

patient need a little more or a little less? And we use digital syringe pumps instead of an IV bag so we can actually do that with the push of a button with great precision. And afterwards, you should turn off, patient rests and recovers for a little while, we'll set them up, offer them, you know, some organic juice, maybe some crackers, give them maybe water, give them a little more time. And then, so with the prep beforehand, in addition to kind of helping to explain the experience and what to expect and answer questions, sometimes there's intention setting there. Sometimes the intention is as simple as I'm just going to be open to what might come up. I'm going to let go of control or I'm going to relax. I'm going to trust.

doesn't necessarily have to be some big puzzle you're trying to solve. Some people do have that and that's fine. But I think in this space there's a lot of conversation around intention and, you know, prep and integration. And I think that can put sometimes an unnecessary pressure on people to, you know, have these epiphanies or to have these specific goals. And if they have them great, if not, that's not necessary. And then as far as on the back end, that integration is not really psychotherapy.

It's more just the nursing team, again, holding space, helping them to process a little bit what might have happened and anything they might want to share. People are pretty, you know, altered after the infusion. And they're conscious and awake the whole time and they can, you know, speak and everything. But you often feel like maybe you've had several glasses of wine, tired, maybe a little bit dizzy. And the experience is so, it really is psychedelic. it's really outside of language. It's really hard to try to put it into words, especially immediately after. So if people want to share great, if not, no pressure to, they don't need to do anything except just rest. And so we create that space for them. And then they'll continue to do more

deeper work on what might have come up with them. And just laughing at your cat there. We will encourage them to do deeper work and talk therapy with either the current therapist that they're working with, or we can refer them to someone. So we don't actually do the therapy in-house. With our psychiatrists will do psychotherapy at the medication management visits that people have if we're managing their prescriptions ongoingly. But we don't really do in-house psychotherapy

directly related to the ketamine. I mean, that being said, we are always available to patients. So sometimes people do want to call and kind of talk to someone and ask some questions about what they saw or experienced or get our feedback. on kind of things and that's totally fine and we're always available to patients for that. But we refer out for the psychotherapy piece and we're big advocates of that.

Yeah. And definitely think it's important for everyone whether you're having ketamine infusions or not. So yeah, I don't know if that answers your question, but that's the kind of overview of the process for the most part. I guess one more thing I'll add is it's a series of six infusions over three weeks. So people are coming in with the prep, the infusion, the recovery, it's about a two-hour office visit. and that's going on for, you know, two to three weeks, six visits. And usually people feel better within two or three infusions at the most. They start to see notable improvement.

It can happen as soon as hours after the very first one. I mean, we've had patients literally sit up and go, oh, my God, like the weight is lifted. Like, that was incredible. I feel amazing. I haven't felt this good in, you know, 30 years. That's not typical, though. And but even just with several days, I mean, we're talking less than a week that somebody who's had intractable, you know, treatment resistant depression for 10, 20, 30 years,

and then within a week they feel great. It's really incredible. I mean, we have an 83% success rate, and we've been doing this for a decade. That's remarkably high, especially among a treatment resistant population. And most of our patients qualify. They meet that criteria as treatment resistant. And it's just the transformation that the treatment can provide for people is just like nothing we've ever seen before. Yeah, it's truly transformative. Now, I've read some interesting articles that talk about the release of BDNF and all these particular types of things that are happening inside the brain. But on another level, no one's really quite sure what the mechanism of action is in there.

You know, it's kind of a fascinating thing to think about, right? Yeah, I think of ketamine as being effective in two primary ways. One is the neurochemical response in the brain with what you're talking about and with the brain chemistry and what's going on there. And that's something that we're still looking to understand. And then the other one is the experiential component, a kind of psychological part of it. And so with what you're talking about, yeah, we know that it's an NMDA receptor antagonist and it causes an increase in the neurotransmitter glutamate, which is actually the most

abundant neurotransmitter in the brain. Some of the other ones that people would know of would be like serotonin, dopamine, noraphenephrin, all the other neurotransmitters combined make up only 15% of the presence of them in the brain. Glutamate is actually present in 85% of the brain and is the most abundant. Interestingly enough, it hasn't really been focused on much for mood. So I find that to be a little bit. But so that's one of the reasons why ketamine is so effective is it just has a totally different mechanism of action. It works in unique ways that none of the other medicines on the market work under. And it does also cause BDNF brain-derived neurotropic factor. It can actually help to, you know, stimulate physical growth in the brain in areas like the prefrontal cortex.

It increases dendrite density and connectivity, helps neurons to wire better together. When you have a depressed brain under a scan, you can see there are parts that are involuted that actually shrink or smaller or underactive. Ketamine breathes life back into these parts of the brain and plumps them back up and increases their connectivity. It helps with increasing neuroplasticity, just forming new connections in the brain. It's really powerful, measurable healing that's going on, not just covering up symptoms. And virtually everything we've had up until now has been really just covering symptoms. And the quality of relief is just not even in the same ballpark.

You know, when someone takes an SSRI and it helps them, oftentimes they feel locked in and like a shell of themselves. And the way that it helps them is the lows of their mood are not as low and they're able to function better, which I acknowledge is very important and is progress. But they don't experience pleasure. They're just kind of flat and existing. And that's not what I would consider success. And ketamine really restores pleasure. It really helps people have more compassion for themselves and others to feel more connected and have the full spectrum of the human experience. And that is what we want to see.

We don't want people to just exist with a little less misery. We want them to thrive and feel good. And so that's what's most exciting about it, in addition to how fast it works and how reliably it works, is the quality of the relief that we're talking about. And I think that's something that gets kind of overlooked when you talk about success with medications. Because there's a lot of medications that, quote, work,

but the whole slew of side effects are so awful. It's like, is that really a success, you know? Quite a cost. You know, you end up having to take two new drugs to cover the effects of the other one drug. It's like a lot of polypharmacy out there. A lot of people on a lot of drugs for and dealing with, you know, a lot of negative consequences that, especially long term. I mean, people in my own family who have a number of real issues from taking higher combinations

of these medicines for years and years. years and they do have negative effects. The other side of this is like I mentioned the psychological component. So ketamine is a dissociative anesthetic. FDA approved in 1970. And we're using it off label, which just means it's it's found to be effective for something other than what it was originally approved for, which was anesthesia. And so it's really, in addition to me to dissociative anesthetic, it's really also a psychedelic. I mean, it's, you know, some people will kind of debate this a little bit, but it has, it is, it is very much alike other psychedelics, such as, you know, psilocybin, you know, like the key ingredient in magic mushrooms,

active ingredient in magic mushrooms, or LSD or, you know, others. And there are also some really meaningful differences between it and them. However, it's psychedelic. And so that experience that people have, the dissociative experience can manifest itself in many different ways, but that is a potent, powerful part of the treatment. And this is something else that people debate, you know, because there's a lot of big pharma companies now that are actually trying to get patents on and manufacture medicines that affect the brain in similar ways

without the psychedelic effects. And I think that's a little bit silly. There's a class of people out that view these as negative side effects that should be gotten rid of or that are inhibiting a more commercially viable model because if people are altered, maybe they don't want to be if they're altered it lasts a long time. You know, like mushrooms, you're going to be, you're going to be feeling it for like four hours, you know, so if you want to, we're moving into the world now of having, you know, psilocybin as a

therapy, places like Colorado and Oregon rolling out programs and thank God Gavin Newsom just signed a bill to decriminalize psychedelics in California and to make them available for physicians to prescribe when they are rescheduled by the Fed. by the FDA, which is great progress. But I feel like I'm kind of getting off on a tangent here. But the point that I wanted to make is simply that the experience that people have during the infusion, we see as hugely valuable for them therapeutically because what they're able to do is work through past trauma that they've suppressed or that they couldn't think about

without being too emotionally triggered by it. And it allows them to give a new perspective on that trauma. You know, the past is set in stone and cannot be changed. But our perspective on it can and is malleable and how we view ourselves and our role and what happened. And the compassion we can feel for ourselves or others is malleable and can change at any time. So people get closure and clarity on the past. They get insights into who they are. and into maybe patterns that are not serving them in their life today,

a clarity on things that they want or need, even just to feel a sense of oneness and wholeness connected to the universe, mystical experiences, people, you know, seeing or interacting on a spiritual realm with what they pursued to be God, or, you know, even just being in a deep meditative state where you feel utter peace and just contentment, very healing for people to have that experience. So we really work hard to create this serene and safe environment where people can really let go and relax and just be open.

And that's hugely therapeutic. And again, it has many, many, many different ways of occurring for people. And it's different, not just for different people, but from one infusion to the next. So what George experiences on his first infusion is almost surely not going to be what he experiences on his second. And we've had people cry for an hour straight, but it being very cathartic. and them going, wow, I haven't cried in years. I needed to release that. My emotions have been so pent up.

I lost my father last year. This happened this. This happened that. I had divorced. And I haven't cried about any of it. So it's huge for them to release that. And on the opposite end of the spectrum, too, we've had people who were singing or laughing for an hour straight.

And just in a joyous state. So it's a really, it's a cool thing. It is a cool thing. when we speak about patterns and language and people begin in perspectives and disassociative, like in some weird way, like that all comes together for people to thoroughly understand what's happening. And I think most people that have found themselves in that heightened state of awareness, be it through ketamine or psilocybin or maybe even breathwork, what an incredible moment it is when you can perceive a traumatic event that happened to you

in a third person perspective in your own mind. Like, wow, releasing the emotion, releasing the blame. And all of a sudden, like, I get goosebumps just thinking about it. It's such a transformative moment. You go, oh, my God. I don't have to worry about that. Like, it must be really an incredible experience to be part of that healing on an ongoing way. It's the reason why I do this work.

Yeah, I can imagine. You know, I'm not a clinician. I'm the CEO. So I'm doing the all of the business stuff. And I still have the privilege of speaking with patients from time to time. My role is much more removed from that work, though. And I end up often with a lot of difficult and complicated things that I do alone because that's my role. And just being part of being the driving force behind those experiences that people are

having is why I do this because there's a lot of things in my job that I don't like. But it makes it, and I guess anyone could say that. But for me, it really makes it worth it more than anything to be a part of helping that create that transformation for people. It's just so cool. It's just no way to describe it. It's really, really meaningful. I might have a way to describe it, and I'll try to put it in the form of a question for you. Yeah. As the CEO of ketamine clinics, KCLA, you're at the forefront of ketamine infusion therapy. How do you see the intersection of science and spirituality in the healing process for patients? Oof, that's a great. I'm like, we're going to add an hour for that. I haven't even got

started on my question. Oh my God. I know. I know. That's a great question. I think that generally Western medicine has been very afraid of anything even in the realm of spirituality. And And there's a much bigger separation there even than church and state, you know, in this country, which is kind of funny, right? But I think that the world is waking up. I think that people are starting to realize that we've neglected our emotional and spiritual wellness in ways that are manifesting into mental and physical illness and that diseases are coming from a dis-ease that people have with the world and life and that the way we're living is not

in harmony with ourselves and the planet in ways that we cannot continue to ignore, whether that's climate change or the suicide rate going up over 20% over the last 20 years or the amount of addiction and just all the things that have been going on in the world, in today's world. And so I think people are definitely waking up to the fact that. that we need to have more of an emphasis on a more holistic model to our health and wellness and the planet. And definitely with that comes spirituality. And that can look many, many different ways. And there's not really a right or a wrong way, I think, so long as you're not causing harm to yourself or others. And you're not oppressing people with a viewpoint. And having some sort of awareness,

of or connection to a power that be greater than you, even if it's just the mystical, you know, awe-inspiring nature of the universe and the connectivity between life on this planet, be it the trees and all animals and just the beauty of that and how we're all really much more alike than we are different, whatever that might be. So I don't know if that answered your question. Yeah, it's a beautiful answer. It speaks volumes of where I think we're at in this world. I think that's part of the psychedelic experience is waking up to the idea that you've been scared your whole life. Like there's been this fear that you've been conditioned to have since birth in a way and that your trauma, regardless of what it is, is probably a symptom

of the society we live in. And our suffering is the one thing that we share that bonds us together. And we're so protective of it. Like, don't look at my suffering over here. I'm a fear of this. But that's the one thing we have in common. Yes, yes. Yeah. Yeah. In minor ways we differ and in major, we're the same. And I think people are, you know, coming to terms with that. And it's, you know, it's progress for sure. I think, you know, especially with the pandemic and the kind of collective trauma that we all experience, the fear and anxiety and not knowing loss of jobs and businesses and not able to see family, make family members passing. All this. A lot of, I mean, there was a 200% increase on anxiety, depression, or maybe even up to 300%, but substantial multiples of what it was, you know, pre-pandemic during the pandemic. Child abuse, substance abuse, spousal abuse, all went way up. I mean, lots of problems that people were dealing with and are still feeling the effects of. I mean, I still have friends today who are just not social anymore, not nearly what they were before the pandemic.

and a lot of people became, I don't want to say antisocial, but just like never recovered from being in isolation. They don't feel like they can connect with people as well. They don't want to be around people. Maybe they feel really uncomfortable in large crowds. I still sometimes see people who are wearing a mask in a room by themselves. I mean, it's like really affected people. And so with that, I think there is more of a shared collective experience

that people are more willing to talk about. It's a little more socially acceptable to talk about your trauma. You know, trauma is interesting. I mean, that really is the root cause of most of the mental health conditions that we see today. And I mean, even way pre-pandemic, just you look back at what is really behind them, it's almost always trauma in one way or another. And trauma doesn't always have to be extreme examples that people might think of, like a soldier in war or something like that, are getting, you know, shot on, you know, mugged and shot on the street. I mean, obviously, those are extremely traumatic things, but there's so many other layers to what trauma. can be and look like that affects people. And I really believe that we're moving in a direction

where we're finding that many mental health conditions are not really entirely separate illnesses in and of themselves, but really symptoms of the illness. And that different manifestations, and that illness really does come down to not even an illness as much as life events, but to trauma. And, you know, that'd be anxiety or depression or addiction. I mean, so many people who think of addiction as a disease.

I mean, most people who are using substances are self-medicating because they're in pain. So I see you have to go a little further back to the, it's the anxiety that's intolerable, that they have to pick up the bottle or take the pills or smoke the joint or whatever they're doing to try to live through that. Or it's the depression that's just so painful that they want to numb that out and don't want to feel it. it's not that they have some weird brain that's different from other people's. And even with anxiety and depression, are those really the illnesses? Or those learned, you know, learn behaviors and symptoms of former stuff, a lot of it going back to childhood? Yeah.

In some ways, you could even break it down to stories they tell themselves for over a period of years, language that this internal dialogue that has become a groove in your brain that became a story. It was a word that became a thought, that became a story, that became a pattern, that became a habit, and now you're living that thing. But this gets back to your personality. It's who you are. We are, we are our language. The word you use explain who you are. But that gets us back to ketamine and psychedelics in this idea of neuroplasticity. If you can begin to see patterns differently, you can explain them differently. And then you yourself can become a different pattern. thus all your relationships change and it can happen the moment you realize hey i don't have to think

about it like that the moment you can change your pattern it's it's so liberating in so many ways man you know what i mean it's mind blowing yeah i love your passion i love it yeah it's right on the money man it's really it's exciting stuff for sure it's uh you know i heard a quote that for the people who are so specializing those who like to snowboard or ski but that you know these ruts as you describe them which such a great word because they really are, you know, that, you know, it's like you're going down a run on the slope and you're going to go into the tracks that have been tracked out deeply from all the other runs before. You're going to fall into them and go down in a similar way. And when you take a psychedelic, you have a diffusion

with ketamine, it's like fresh snowfall and you can go down the run any which way you want. And it really is like that. So it's not that ketamine or other psychedelics are necessarily just creating this blissful utopian life for you. But then give you. the opportunity to reset to, you know, choose different patterns and create new ways of being. And with the right support and with a more positive mindset and better function, those often do end up being really positive patterns. And disrupting the language, definitely, I mean, we think in language and our stories, as you said, is so really profound and so true. And there's really very little out there that's affecting us in reality.

99% of our experience in this life is that internal monologue and our perspective, our mindset is everything. There's extremely impoverished people who are some of the happiest people in the world. And there are some of the wealthiest people in the world who are absolutely miserable. And so having all the connections, power, resources, money, all the material things that people think, well, if I got to that level, then I'd be happy. The reality is that's just not true. I think and hope people are realizing that more today as well.

So we have a lot of really successful. We have celebrity patients and very, very wealthy patients. And a lot of these people are absolutely miserable. And, you know, it's just, it's just, there's no, the only thing is the mindset. And I've experienced this quite profoundly in my own life. And coming to terms with that, you know, is really empowering because then you realize, you know, when you see more that your outer world is merely a reflection of your inner world and you have control over your inner world, things start to show themselves in ways

that are really beautiful for you. The same way you can go outside and see the vine creep up the palm tree and it knows to produce a fruit at a 47 degree angle on August 23rd at 3.37 p.m. so too does your life unfold in front of you if you just get out of the way. That's great. That's great. Yeah. Absolutely. Well, yeah, it's funny.

I think, you know, so much of the time we want to try to manipulate and control and force outcomes in our lives. And the more we focus on, you know, being the magnet and attracting things into our life that we want, trying to be our best self. I mean, another quote I heard recently that I love is, If you chase butterflies, they fly away. And if you build a beautiful garden, they will come to you. And I think most of us, self-included, I spent a lot of time running around trying to catch

those butterflies. You know, when I'm getting real frustrated doing it, thinking, oh, if I just run a little faster, maybe if I get a bigger net, you know, maybe if I move a little more quietly, and all the reasons why you're going to be able to get that butterfly. When you stop for a second, and this is really this inner work, right, and really being the best possible version of yourself that you can be, when you just make a beautiful garden and nurture it and relax and trust and build and build, you're going to have so many butterflies you don't even know what to do with them all.

On some level, like, we've been speaking about mental health and people coming to help traumatic events, but wouldn't this same methodology also apply to learning? Like when I see so many people like my age, I'm almost 50. No way. Yeah, man. Yeah. You'd be like 30, man. I feel like it.

I mean, you got the energy of a 50. 15 year old. My wife says I'm on the same maturity level of them as of them. Yeah, I got that going for me. I can see that. But you ask better questions. Absolutely. I do a lot of psychedelics, you know.

It's delightful things to say, yeah. Well, that's, that's probably why you look at the young and have even more energy. Thank you. But I think it speaks to this idea, especially where we are right now. Like, there's a real opportunity. And we see the world transforming so rapidly, but not just transforming you with the rate of change is also accelerating. And so might this particular therapy not only be something we use for health, but optimization.

Like it can really help you learn in ways that might not have been given to you before. I think you're much more receptive. In some ways you may have the neuroplasticity of someone in their teenage years. So when I read a book now after, you know, if I do a psychedelic, I can tell that I am picking up information much more readily. And it seems that I have the ability to not only pick up that information, but to recycle it in my mind and then write it back down. So it seems as if my ability to learn is enhanced a few days afterwards, maybe a few months afterwards. I've seen some studies that say that. But might the same therapy we're using for mental health and wellness be attributed to learning in the future?

Like I could see this being part of an athlete's program to become the best. I could see this as a scholar's program. I'm like, now these might be out there ideas, but I don't see why not. I think that if we have and we're able to pinpoint neural plasticity, might this open up a whole lot of new avenues in a lot of different areas? I think absolutely 100%. And I wish there was less stigma around ketamine as a drug that people do use on the streets, a special K.

A lot of people know it as a horse or a cat tranquilizer because it's used in veterinary medicine, which it is. but it's a human anesthetic FDA approved for humans. A lot of people don't realize that. And it's a ubiquitous drug with many uses. It's also analgesic. It's a pain reliever. You know, it's used for conscious sedation and, you know, helpful in general anesthesia.

It has a lot of different applications. And now over the last 20 years plus becoming really prominent mental health treatment. But it is a stigmatized medicine. And that, I think, really is unfortunate. And it kind of is getting in the way of some of the other applications you can have, like you're mentioning. I think ketamine could be really wonderful just for general health and wellness for anyone. I'm not saying that everyone should have it.

Right, right. And there are definitely some people who should not. However, I don't believe that you need to have a mental health diagnosis in order to benefit from it. As a matter of fact, I know that you don't. However, as a business in California, under the regulatory laws that we operate within in the legal framework, we do require a diagnosis.

We do have to be, you know, it's a controlled medicine. We do have to be treating a confirmed condition and document it. And, you know, doctors can't just give people drugs for any reason they want. They got to have a good reason to do it. And that is where we're at today. My personal view, and that's how the business operates, but my personal views are definitely that there could be a future, and I hope sooner than later,

where people can experience it for wellness, for learning, for athletic performance, for general maintenance in life, because this neuroplasticity is really profound for really any application in bettering yourself as a person and in reframing the way that you're approaching life like we've been talking about, disrupting patterns. All of us have negative thoughts, negative patterns, ways of thinking and being and occurring, and they can compound and persist, and operate at different levels of severity for different people. But we all struggle with that all the time. So what a gift it is to be able to kind of hit a reset on that

and have an opportunity to almost start fresh in your routine. Yeah, without a doubt. Another aspect of this that could be coming down the pipe and I've spoken to everybody from biohackers to mental illness to people working with addiction and, of course, my own experiences. but I see this sort of harmonious bond between body and mind. And when I think about psychedelics paired with something like HGH, in my particular experiments, I found it to be an overwhelming success

and not only comprehending patterns in my life, but also a feeling of growth inside my body. And I'm wondering down the line, do you think that maybe there may be something to be said with layering? You know what I mean by that by using multiple things together? Yeah, I think that's really interesting. I don't know a lot about human growth hormone. I know very little.

I don't know anything about, you know, it's potential combinations with ketamine. I think as far as mixing ketamine with other things or layering, as you put it, there's some interesting possibility there. Some people are doing some interesting stuff with TMS and ketamine combined. Because TMS also helps to create neuroplasticity and help with brain function. and, you know, the formation of new neural pathways. And so kind of combining them. And they have different mechanisms of action, different ways of achieving that in different

parts of the brain. So kind of combining them together almost forms a new treatment altogether. It's not just doing two different treatments, but actually forming almost like a third kind of treatment that's unique to itself. Yeah. Yeah, I think there's a possibility. I mean, the other thing is just nutrition, you know, is and hormonal stuff. Because, you know, I guess back to the HGIS, you know, we had a patient who,

tried a number of infusions didn't benefit and then had his testosterone levels checked, they were extremely low, almost dangerously low. He had them corrected. And then, and he, he hadn't benefited from the treatment, had it correct, it came back and had a wonderful result from the treatment. And really grateful that he stuck with it and didn't give up on it. And we've had other situations similar with really severe, you know, vitamin or other hormonal deficiencies that needed to be corrected that were actually, if not causing or contributing to the, symptoms they were dealing with in the first place and definitely preventing them from benefiting from the treatment.

And so I think definitely as we move more into a more holistic model as a healthcare system, and it's one that we feel is important is treating the whole person. Because only Western medicine says this one little part of this one thing is the problem and ignores the rest of the entire system. I mean, our bodies are vastly complicated and complex and interconnected in every way. I mean, it was I think 95% of serotonin is made in the gut. Yeah. I mean, that's wild.

We're only just starting to scratch the surface on, you know, the gut and the gut brain axis and the mind-body connection. And, you know, all this kind of stuff is like, we're just starting to get into this as a, you know, I feel like as a society and even to think about it. So, yes, I think for me, the obvious low-hanging fruit is starting more with that stuff than necessarily other supplementation. And looking at are your, is the nutrition and the hormones, right? And if not, what can we do?

And are you really living a healthy lifestyle? We believe in the pillars of wellness. So, you know, fitness, healthy nutrition, adequate sleep, you know, personal, meaningful connections, relationships with people and talk therapy. And so those are core things that we feel are really important for everyone. And, yeah. I love it. I love the idea of us beginning to figure out, you know, ideas like serotonin in the gut.

I once had a discussion with Dennis McKenna about that. We were talking about serotonin. And I said, what do you think is happening with the mechanism of action with serotonin in the gut? And he just looked at me and he's like, I don't know. We're talking about the brain, George. Why don't you figure that out? So I'm so stoked to have a conversation and asking that. But yeah, we don't really know.

And we don't thoroughly understand. what's happening. But what we do and we are we we are beginning to understand is this idea of relationship. And it's in all the way through the psychedelic experience, whether it's the serotonin in your stomach in your brain or the way you think about things or the way you act with your body. But this idea of relationship is really sort of at the root of what we're talking about. Yeah. And you know, speaking of roots, Western medicine sees a plant with brown leaves and they go, oh, it's got brown leaf disease. Or the leaves have fallen leaf disease.

But maybe the plant just needs some water. Or maybe the soil needs a little more nutrients. Maybe it needs some sunlight, you know? And so I think we are ultimately talking about moving into a world, a brighter tomorrow, hopefully where we can look at these plants. And instead of throw a label on them and throw a drug at them, we can say, let's give this some of what it really coordinates at its core needs to function better. It'd be healthier.

That's some water, some sunlight, maybe some fresh soil. oil. Yeah, I agree. It's, it's a fascinating concept to see the world changing as fast as it is. And I have a few questions that I was thinking about going, but I know we're kind of getting close on time. I guess one thing. Really, really, really fast. Okay, let me go. As someone deeply involved in mental health care, what philosophical principles are ethical guidelines guide your decision-making? at the leadership at KCLA.

Patients come first, always. Always be right by the patient. If you genuinely serve people with compassion and integrity, it will pay dividends. Making money and helping people are not mutually exclusive. You don't have to choose which one you want. That as a matter of fact, the more value you add to people

and the more that you help them, and the more good that you do, the more money you will make, and treating each person as a unique individual and finding what it is that they really need in order to feel cared for. Also, the power of that and of the therapeutic relationship and how much of it is sadly absent in our healthcare system in the United States today,

that just showing people that you genuinely care about them and you want to help them and you're going to do everything that you can to help them without making promises is healing in and of itself. And for a lot of our patients, it's the first time that they've really felt hurt or cared for or understood. Outside of the really fantastic results that the treatment is providing, just that is like a treatment on its own. And so really passionate about that. And the set and the setting.

So helping to prepare people's mindset for the experience, which is, you know, classic, you know, essential pair in any psychedelics, right? your mindset and then your setting before you do it. But yeah, we create a really beautiful and serene environment and just have a wonderful team and really just make an experience for people. That is peaceful and full of genuine love, quite frankly, good passion for them. That's really what guides everything that we do. Also, I would say like with this, like with anything, I mean, we really took the approach of becoming masters in it by putting everything we have into it. And I think there's a lot to be said for being a little obsessive about one thing, you know, as opposed to just doing lots of things decently. And only is after a decade of doing

this in the last year, do we decide to add other services and grow in new ways. So day in and day out, our commitment to excellence, to refining, to always improving no matter how great we were doing, to never resting on our laurels, to always say, well, how can we do this better? How can this be more efficient. How can this be smoother? How can patients have a better experience? How can our staff be less stressed? How can our teammates do this amazing work they're doing with more freedom and ease? And always asking these questions, day in and doubt, for years, we've really got a good thing going with it. It's been really hugely helpful, I think, to patients and to us to approach it in that way. What a novel idea to care about the patient and provide them a space where they can heal instead

a profit. I can't worry. I know. It's kind of crazy. It's kind of crazy. Yeah. Yeah. That's the other thing I'll say. Going against the grain, we have not been afraid to stick out and to do things our way. And I would recommend more people to do that when it comes, when they're guided by integrity and doing good things, you know, when we started out, this was so, seen as so fringy. And we have people saying, you're experimenting on people. people, you know, how can you do that? It took so much criticism. And now the treatment is much, much more mainstream,

though it's still a lot of misinformation, a lot of ignorance, a lot of people still don't know about it. And there's still stigma. But when we started, it was like night and day difference. And I think, you know, for us, the proof is in the pudding. The results speak for themselves. When we had our early patients who had enormous, like just wonderful transfer.

for themselves like anything they had ever had before. It didn't matter what the criticisms were, the risks, the potential scrutiny, that it wasn't the norm, that we were outside of, you know, the standard of care and the community and all these things. And, you know, doctors and professionals in general are very afraid of litigation. We live in a very litigious state, unfortunately, in California, very afraid of licensing boards, very afraid. I'm not saying you should do things that are outside of the law.

We never did and we don't. But really pushing things to the edge, you know, of the limits based on moving the field forward. And I wish more people took those risks. I really do. It's the only way to grow. It's the only way to have positive change. If everyone just falls in line and does what everyone's always done, what are we doing? And that might be okay if what we had always done was super fantastic, but it's not.

because what we've been doing is not working. And that's the definition of insanity, right, doing the same thing over and over and expecting different results. You know, how many more SSRIs are going to fill for how many more years before we realized, like maybe that's not the solution to what is going on with people's mental health today. Not to say that it isn't a tool or that they're bad. I'm not saying they're bad. It can absolutely be helpful.

But that's not where we should be stopped at, you know, with innovating upon how we take care of people. those are all really well said and beautiful points and i'm so thankful that you put it that way because i think that on some levels it just speaks to overcoming fear but but you know what else i think that you guys are doing that no one else is doing is you have found a way to measure the subjective the subjective results of success that people have been pushing away for years the warm the warm flowing tears of the mother who gets to see their child again relive their life. That is success beyond measure.

But yeah, it's non-Euclidean space, so I can't put that in the lab. Yeah, yeah, yeah, yeah. You know what I mean? Like, you guys are at the forefront of measuring success in a way that other people can't. And by doing that, by sticking your neck out and doing that, you're paving the way. Because those results matter. That is the human component to success. And too many people have pushed that away for too long.

You guys are pioneering that, man. I love that. Thank you for doing that. Well, thank you so much for the acknowledgement. Yeah, yeah, definitely. Yeah. It's a great point. We haven't been afraid to have that those measures that are outside of the traditional measures and even things that are not so measurable or harder to quantify or aren't quantifiable. I had someone asked us to me recently because we use, we use, you know, standard mood assessments. We use the back to the Madras, PhQ9, GAD 7. I mean, these are all assessments that measure people's move. We put numbers on a graph. We can see up, down, et cetera.

We like data. We like science. And it's not the whole world and everything, you know, in between. There are some things that are outside of that, right? Yes. And so I was actually explaining some of these assessments. And I said, and also we use some qualitative assessments as well. And, you know, that's not the only thing.

And they're like, well, what do you mean? And I was like, well, the results that patients have in their lives. And like, well, what do you mean? How can you measure that? I said, because the mother's playing with her child after two years, I'm feeling like she couldn't get off the couch. And she actually asked her husband if he wanted to go out to dinner, which they also haven't done in years and was intimate with him.

And they were connected and was smiling and actually decided she felt well enough to go back to work. So these are some of the ways that were like, yeah, this is success. And fortunately, they were like, oh, yeah, that's good. Okay. But like people have a hard time kind of understanding like we're all, we're human beings and ways we can see when someone comes into the clinic who was really unkempt. And the week later, they're, you know, their hair is brushed and they're wearing some clean clothing and you can tell they took a shower that morning and things that were really,

really hard for them to do before. That's success. This person feels well enough and energized enough and cares enough to actually put some energy into their hygiene into taking care of themselves, you know? Yeah, I do know. I love it. It's so beautiful to me. And I'm reminded, I had a recent conversation with Dr. Erica Dick, who is a sort of a historian on the world of psychedelics. And she had mentioned to me that in the 50s, there was a very similar time right now where in the late 50s, psychedelics was embraced by this container of medicine. But the ways in which they measure things,

was a lot different. They actually had questionnaires. Like, is your husband less of an asshole now? Like, you know what I mean? But that's relevant. It's so relevant, right?

Yeah. And I'm so happy to see us getting back to this human component. And I can't help but think that the psychedelic experience is just this for some people. I know that it can't be for everyone. And it's not a panacea. But, you know, it brings back the idea of relationships. And Sam,

before, I know we're up on the hour. You've been gracious with your time. You're going to have to come back. I got through like two questions. I love it. Before I let you go, what do you have coming up? Where can people find you?

And what are you excited about? Well, we've been expanding our services. TMS is something we're really just getting going. It is covered by insurance. It's an effective FDA-proof treatment for depression and OCD. So we're excited to roll that out and for people to be able to benefit from that. people can find out more at ketamine clinics.com. It's K-E-A-M-I-N-E-C-L-I-C-S dot com.

Lots of good info there. We offer free consultations. If people want to call us, they can call us at 310-2-7-0-6-25. No obligation, ask questions, talk to a clinician, whatever, any way we can support them. And what am I excited about? I'm excited about the really great progress we're making on decriminalizing psychedelics. I'm really including just, you know, this week in California. And it looks like Cellicidin and others are really starting to follow in the trend of cannabis.

And I find that to be very exciting. And I'm excited, speaking of cannabis, for that to be rescheduled federally that it couldn't come soon enough. know when they're going to do it. They've been talking about it for so long, but it's insane to me that it hasn't been done yet. I'm really excited about MDMA assisted psychotherapy and the stuff that, you know, MAPS is doing, been doing with Rick Doblin and MAPS for 38 years now on making that happen. And it looks like his lifelong dream is about to come to a reality early next year and, you know, Q1, Q2 of next year, it looks like we're going to have MDMA legally available as a treatment. And that's radical. And so I'm excited.

for that and for the rest of the psychedelics to follow suit soon in California as well and for us to incorporate them into our practice. I believe these really are the solutions to or part of the solutions to real meaningful healing for people. And I find that to be really exciting. And as you said, and you know, we're both so passionate and there's so much to talk about this. And some of the critics will say psychedelics aren't for everyone. And it's like, yeah, we never said that. And so let me just be really clear. Psychedelics are not for everyone. They're not a magic bullet. As you said, they're not the panacea. They're not perfect, but they are pretty damn exciting and they have a lot to offer. Yeah, I couldn't agree anymore. So hang on briefly afterwards. I'm going to talk to you briefly

afterwards, but I've got to hang up with our people. Ladies and gentlemen, thank you so much for hanging out with us today. Go down to the show notes. Check out everything that Sam has going on. Do your own research, but reach out to them. He's a friendly individual. They got a great operation going. And if you know someone in your life that is going through some struggles, look at all the options and see what's out there because the world is really changing right now. And there's a lot of things that can really help people. So that's all we got for today. Ladies and gentlemen, I hope you have a beautiful day. Aloha.