For many people, taking a psychedelic like psilocybin is one of the most revelatory, profound, bizarre, beautiful, notable experiences of their lives. I’m one. It’s hard to enumerate all the things psychedelics have done with me, to me, and for me, but, given that a metastasizing squamous cell carcinoma is likely to end me, reducing my fear of death is a big one—albeit not a virtue I imagined would be germane so early in my life. I thought I’d have many more bike rides, walks with my wife, Bess, cups of coffee, and books to read—but treatment-refractory cancer means that I’ve been hit with the existential slap sooner than most. In another essay I testified about the powerful effects psychedelics have had on me:

Part of being ready to die comes, I think, from psychedelics; I wrote in “How do we evaluate our lives, at the end? What counts, what matters?”: “Bess and psychedelics taught me to love, and the importance of love, and yet too soon now I must give everything back.” There’s a longer, yet-to-be-written essay about how psychedelics cause me to see myself as a tiny instantiation of the vast, interconnected human whole, which will comfortingly go on even when I flicker out.

Michael Pollan’s book How to Change Your Mind is great and also covers a lot of existential territory. I’m looking for a copy to quote from and can’t find it, because I’ve given so many copies away. Pollan describes the way psychedelics are being used palliatively for end-of-life care, which is, strangely where I now find myself. Fortunately, I have a Kindle copy, and now I can authoritatively say that Pollan writes about how “researchers [have] been giving large doses of psilocybin—the active ingredient in magic mushrooms—to terminal cancer patients as a way to help them deal with their ‘existential distress’ at the approach of death.” Moreover, for many people, “psychedelics [help] to escape the prison of self.” I guess I can say that psychedelics prophylactically assuaged my fear of death, the way Zofran might be taken to prevent nausea.

Even before the present circumstances, from psychedelics I learned how not just to know but to deeply feel and internalize that we’re all part of the show for such a short time, and then it’s someone else’s turn, and that is okay. Until science radically expands healthy lives—which will be great, but it’s not clear whether we’re near to or far from that series of breakthroughs—we’re not here for long, and then we yield up the gift, whether willing with grace or unwillingly with fear.

In How To Change Your Mind, Pollan writes that he “interviewed at length more than a dozen people who had gone on guided psychedelic journeys” and found that, like me:

For many of [the people he interviewed about their psychedelic experiences], these were among the two or three most profound experiences of their lives, in several cases changing them in positive and lasting ways. To become more “open”—especially at this age, when the grooves of mental habit have been etched so deep as to seem inescapable—was an appealing prospect. And then there was the possibility, however remote, of having some kind of spiritual epiphany. Many of the people I’d interviewed had started out stone-cold materialists and atheists, no more spiritually developed than I, and yet several had had “mystical experiences” that left them with the unshakable conviction that there was something more to this world than we know—a “beyond” of some kind that transcended the material universe I presume to constitute the whole shebang. I thought often about one of the cancer patients I interviewed, an avowed atheist who had nevertheless found herself “bathed in God’s love.”

During my first psychedelic journey, I epiphanically understood visual art for the first time. Time and space seemed malleable. I saw life as a series of information problems or logic gates, and the stripping away of life’s surface to see what’s underneath helped me not fear the unknown. Logically, I understand that there’s no reason one should cause the other—that stripping the surface should help me not fear the unknown, including death—and yet that is how things unfolded for me. Feelings became more real to me. Like many people, my ego dissolved and allowed me to merge with all of life. Dying ceased being scary.

I emerged from that psychedelic with a great appreciation for love, which, along with progress and continuous improvement, is one of the great binding forces of the universe. But love can’t be indiscriminate: any person should be judicious in who they bind to. So many people don’t seem open to love, or to understand that it is an action verb and a skill that should be cultivated, and so their capacity for love shrivels like an unwatered plant. Maybe they’re not being giving enough, but being too giving and accepting of others, which puts a person at risk of scammers, parasites, and similar problems. Too much defensiveness can be just as problematic as too little.

Although I’m not in my 50s (like most of the Pollan interviewees; I’m also extraordinarily unlikely to ever reach that age), psychedelics dramatically increased my self-perceived openness. I don’t wholly know what I think about life after death or what is beyond material experience, but, regardless of what there is or isn’t, psychedelics unlocked a sense of human and technological sublime—and that sense of the sublime lets me see my own smallness in the world, and yet I also have seen that my contributions to the world are unique (like everybody’s, but that’s okay). The sublime revealed itself using what was already in my mind. Psychedelics seems to access my subconscious too, in ways I don’t expect, and psychedelics helped me see myself as lucky in numerous ways—including lucky to have experienced the psychedelic mind state itself, before the end. That sense of gratitude sustains me now, through the horrors of treatment and the loss of the tongue.

I don’t know whether many of the feelings and senses of revelation that psychedelics facilitate are true. They may not be. It may also be that the “truth” or falseness of the psychedelic mindset is irrelevant, like asking if purple sounds good. Psychedelics seem to temporarily short-circuit the logical mind in order to let the imaginative / feeling mind wholly take over, which can, I’d guess, be scary for some people, at least if they’re not being guided effectively, or if they’re not in a safe “set and setting,” to use the preferred psychedelic lingo. I come out of the psychedelic head space and feel utterly different—but am I, or is the feeling a lie? Does the question matter, or do the answers?

It could be that the psychedelic reinforces what’s already there. For example, I was interested in stoic philosophy and life before I took psychedelics, and the taking of psychedelics may simply have reinforced some of the notions I’d already absorbed from books—being ready to die, if that is one’s fate, seems like a stoic stance (particularly given Seneca’s socially meaningful auto-termination). Perhaps the psychedelics only slightly ratcheted up the underlying tendency.

I’ve spent most of my life being a thinker more than a feeler, but taking psychedelics balanced me out. It let me do both, and to reconcile apparent opposites. When I was young I think I worked to repress my emotions as a survival mechanism in a milieu that, to put it lightly, didn’t reward emotional expression. That isn’t uncommon, I suspect, since many people who experiment with psychedelics or therapy (and ideally both: psychedelics and MDMA appear to be incredible, underutilized therapeutic tools) find themselves better able to be emotionally expressive and better able to accept the love and affection of others. A lot of us are emotionally shriveled, for reasons I don’t want to speculate on here (despite my penchant for dubious speculation), and treatments that can help that are scarce. Therapy and support groups work for some people, but both work better with psychedelics. Once psychedelics make it through the FDA gauntlet, thanks to the work of the Multidisciplinary Association for Psychedelic Studies (MAPS), we’ll look back on non-psychedelic therapy as not terribly effective—it’ll be like comparing shamanism to medicine. Shamanism may be an interesting topic of study, but if there’s actually something wrong with you, you want the medicine.

Bess eavesdropped on some of the above paragraphs and then came up to me and gave me a hug and a squeeze and said: “I don’t want to do the world without you. You stay.” She gave me a hard slap on the ass and told me it’s decided. I hope she’s right. I’m trying hard to stay, however much psychedelics have made me accept death, without being suicidal or wanting to court death. If I had the skillset to work on treatments to radically extend life, I’d work on them, and I encourage others who have those skillsets to keep working. It may be that understanding and defeating aging and cancer are ultimately the same thing. I don’t have the expertise to evaluate those claims, but they seem plausible from the outside.

I read an interview with the movie director Francis Ford Coppola where he says:

I have no fear of death whatsoever. I used to do a little experiment for the fun of it in my elevator here, when I go down to the first floor. I can control the elevator so when I go in, I shut out the lights and I’m in total darkness. I think, when I get to the first floor that I’m going to be dead. As I go down, I think, I had such an interesting life, I got to be a movie director, have a wife and children, had so much fun with them, got to be in the wine business, go through everything, and as I’m lost in all these interesting thoughts, the door opens on the first floor and I’m not dead. I walk out.

Psychedelics are for me like Coppola’s elevator. Many people take a psychedelic and have the experience of dying while in the psychedelic head space, where it doesn’t bother them. During the psychedelic experience, time also seems to halt, and one hour turns into years.

I’m deliberately not describing the content of psychedelic trips: that content usually seems banal to outside observers, and words are notoriously for capturing the feelings generated in the psychedelic state. Hearing about other people’s psychedelic experiences is like hearing about other people’s vacations—rarely satisfying. The people who can make their vacations vivid find work as travel writers. The shaping of experience through the craft of language is hard, and for psychedelics inadequate.

The last two times I’ve taken psychedelics, I’ve set the same intention before starting: to accept death. But the psychedelic experience is unpredictable; sometimes you get what you get, not what you think you need, and the result is strange and peculiar and worth doing. Both trips were generative and beautiful, though if I learned anything about accepting death, it’s that I’ve probably already done it. Life is a strange trip. The thing I can’t accept, and that will likely trouble me until the last moments, is that I don’t want to abandon Bess, and that I am worried she will be lonely, and no psychedelic can stop that fear and pain. Psychedelics may help many things but can’t help all things. Though I’ve been talking to all of our friends and family about supporting Bess after I pass, I know that she’ll be desperately lonely in a way no psychedelic can ameliorate, and I’ll be dead and so unable to do anything to alleviate the existential pain she’ll likely carry with her always.

If you’ve gotten this far, consider the Go Fund Me that’s funding ongoing care.

Here is Tyler Cowen on why he doesn’t personally use psychedelics. Those reasons seem fine for him but are probably not generally applicable. As Cowen says, there are also probably diminishing returns to psychedelics, which is consistent with most things human do.