Tomorrow is Indigenous Peoples' Day, a time to recognize and honor the enduring contributions, resilience, and wisdom of Indigenous communities. As someone who works in psychedelic-assisted psychotherapy, I feel a deep responsibility to acknowledge a truth that is too often overlooked: the healing practices we now call "psychedelic therapy" are not new innovations. They are the continuation of Indigenous knowledge systems that have existed for thousands of years.

Long before Western medicine "discovered" the therapeutic potential of psychedelic compounds, Indigenous communities had developed sophisticated healing traditions centered around sacred plant medicines. The protocols we use in modern psychedelic-assisted psychotherapy—concepts like set and setting, preparation and integration, the importance of a supportive guide—these ideas come directly from Indigenous knowledge. We have simply given them new names.

As psychedelic medicines move into clinical settings, we risk stripping these practices of the cultural context that makes them healing in the first place. On this Indigenous Peoples' Day, I want to reflect on what we owe to these cultures, what we risk losing when we disconnect medicines from their origins, and how we can move forward with greater respect and reciprocity.

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Why would an emergency medicine and oncology PA choose to specialize in ketamine therapy? And what does the name "Canto" have to do with it?

In this deeply personal essay, I share the unexpected journey that led me from the chaos of the ER and the gravity of oncology to the intentional, transformative space of ketamine-assisted psychotherapy. My background in emergency medicine taught me to prioritize safety protocols and respond to acute medical situations—essential skills when working with ketamine, which isn't without risks. Oncology taught me how to sit with suffering, hold space for difficult emotions, and bear witness to people in their darkest moments.

But after years in academic medicine, I found myself burned out, depressed, and reduced to 15-minute appointments and MyChart messages. I had lost my voice in a system that prioritized productivity over humanity.

"Canto" comes from the Latin word meaning "I sing"—a first-person declaration of reclaiming that voice. It also refers to a verse in a longer poem, perfectly mirroring how each ketamine session is a step in a larger healing journey.

This is the story of how I walked away from corporate medicine to create something authentic, meaningful, and mine. This is my song.

"Joy is a form of resistance." Those five words from a young activist stopped me in my tracks this week, challenging what I thought I knew about activism, guilt, and wellbeing.

In a world that often equates suffering with virtue and busyness with worth, the idea of actively seeking joy can feel selfish or naive. But what if choosing joy—especially when everything feels heavy—is actually a radical act?

This isn't about toxic positivity or pretending problems don't exist. It's about understanding that systems of oppression, whether societal or internal ones created by mental illness, thrive on keeping people depleted and hopeless. When you deliberately seek what brings you alive, you're asserting that your wellbeing matters.

From a clinical perspective, positive emotions don't just feel good—they literally change your brain, creating upward spirals of resilience and connection. For those dealing with depression or anxiety, joy isn't a luxury you can't afford; it's fuel that allows you to keep going.

Maybe what we need most is permission to feel good without justification, to prioritize our wellbeing without guilt. In a world that profits from your anxiety, choosing joy isn't just self-care—it's defiance.

A month into opening my ketamine therapy practice, 12 inches of floodwater swept through my office space. What started as devastation became an unexpected lesson in resilience, community, and the true foundations of healing work.

Sometimes our most profound discoveries emerge not from perfect conditions, but from learning to stay open when everything feels like it's falling apart. This is the story of how a disaster taught me what really matters in therapeutic space—and why the most important element isn't the furniture or artwork, but our willingness to show up authentically with whatever arises.

A reflection on set and setting, asking for help, and discovering that floods can fill us with unexpected gifts even as they sweep away what we thought we needed.

Struggling with compulsive hair pulling that traditional treatments haven't helped? Trichotillomania affects millions, causing shame and frustration when urges feel impossible to resist. Our Chapel Hill, NC practice offers innovative ketamine-assisted psychotherapy for treatment-resistant trichotillomania.

Ketamine therapy may help by interrupting automatic pulling patterns, reducing urge intensity, and enhancing self-awareness of behaviors that typically occur unconsciously. While research is emerging, early clinical experience suggests ketamine's neuroplasticity effects could support developing healthier coping mechanisms for managing this complex condition.

If you've tried therapy, medications, and habit reversal techniques without adequate improvement, ketamine therapy might offer additional support in breaking free from compulsive pulling patterns.