Osteopathic Medicine

09/06/2026

Nine medications failed to touch his depression. The one that finally made a difference is the drug he has used for years to put patients to sleep.

Jim Ellwood is an anesthesiologist who has dealt with drug-resistant depression for most of his adult life. Nine different medications, a string of therapists and psychiatrists, stretches where he did well, and side effects he couldn't tolerate. About 2 years ago, in one of his downs, he asked his psychiatrist what he thought about ketamine. His own first reaction years earlier had been the same as everyone else's. He knew it as an anesthetic and couldn't see how it would help.

He found a program run by ER doctors in a monitored setting with a strict protocol. The first session was strange, and he walked out wondering how any of that was going to help his depression. After a two-week induction period he could feel a difference in his mood and his perspective. He still goes weekly, because the effect doesn't last.

Then he started telling friends and colleagues, and got exactly what you'd expect. "Oh, it's the horse drug." "You're in a K-hole like the kids at the clubs." Other anesthesiologists said fine as an anesthetic, but for depression? Then the Matthew Perry story broke, and overnight the headlines were about a dangerous drug, an epidemic of deaths, people using it to get high and overdosing.

He'd heard this one before. Patients used to ask him, "You're not using that Michael Jackson drug?" Propofol is a great drug, he'd tell them. Very safe. Used all the time. The problem was how it was used. Fentanyl, same story.

Having given the drug and taken it, this is what he tells people now. Ketamine is a powerful drug and it can be addictive, and he's sure the clinics screen for a history of substance abuse for that reason. You can't just give ketamine. Whoever is writing the prescription needs a license and a DEA, so before you walk into a clinic you saw advertised, find out who that person is, and if it's the ophthalmologist, ask yourself whether he's the one who knows how to assess depression. If it's at home, know who is with you and what happens if there's a problem. And if you've tried a couple of SSRIs with no good effect, or with side effects that complicate your life, that's the scenario where he thinks this belongs in the conversation.

He wanted his name on this as a doctor, so that people who have cycled through medications and decided nothing will help would consider it.

Jim put it this way:

"It is a powerful drug. It's only dangerous when it isn't used properly."

Listen to the full conversation on The Podcast by KevinMD. Link in the comments.

09/06/2026

If using AI for writing means you never have to stop, backtrack, or start over, you’re missing the most important part of the process, Eve Fairbanks wrote in May: https://theatln.tc/kt48YTId

09/06/2026

"It strikes me as unfair, and even in bad taste, to select a few individuals for boundless admiration, attributing superhuman powers of mind and character to them. This has been my fate."

- Albert Einstein

08/23/2026

01/29/2026

Make walking and running part of your Osteopathic Wellness Plan.

01/29/2026

Make smoking cessation a part of your Osteopathic Wellness Plan.

01/29/2026

Vintage Osteopathic Medical School lecture and demonstration of evaluation and treatment of somatic dysfunction of the thoracic spine.

06/28/2025

03/23/2025

Autopsies may very well be the medical procedure that Americans have been most exposed to via their screens. But their depiction on TV is so disastrously wrong that it discourages families from opting into these vital procedures—and even diminishes doctors’ understanding of how autopsies work, Samuel Ashworth reports. https://theatln.tc/51T2GDdp

On television, autopsies happen in dark rooms with blue light. They involve scalpels, bone saws. Many of the actors pantomiming these procedures do things that would cause a pathologist to lose their medical license. In real life, “autopsies are performed in brightly lit rooms,” Ashworth writes. “It’s slow, comprehensive work that rarely involves fancy electronics.”

One of the most subtly ridiculous aspects of TV autopsies is how often the doctors lack personal protective equipment. “In real autopsies, the people involved wear head-to-toe PPE … because, when you open a human body up, all the blood, bile, and other fluids that a person had in life are still in there,” Ashworth continues. Errors like these in TV depictions “reduce autopsies to ghoulish spectacles.”

These procedures are in fact a respectful and uniquely useful tool for understanding a patient’s life and death: “Autopsies, even in cases where death was expected, can serve a real purpose to the living,” Ashworth writes. “They help present a full narrative of disease, which can help doctors treat other patients and—if communicated well—allow grieving families to move toward acceptance.”

The rate of autopsies in the United States more than halved from 1972 to 2007. And in hospitals that do offer the procedure, residents—many of whom lack the training to properly describe the process—are typically the ones who have to ask a family about an autopsy. “In that moment, there’s little to stop the grieving family from calling up all the lurid images they’ve likely seen on TV,” Ashworth continues. On TV, “the stark truth of a dead body is either milked for shock factor or smoothed over with holograms … Everyone knows life isn’t like that. We need to accept that death isn’t, either.”

Read more: https://theatln.tc/51T2GDdp

🎨: The Atlantic. Source: Getty.