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“The betterment of well people” is very much on the minds of most of the researchers I interviewed, even if some of them were more reluctant to discuss it on the record than institutional outsiders like Bob Jesse and Rick Doblin and Katherine MacLean. For them, medical acceptance is a first step toward a much broader cultural acceptance—outright legalization, in Doblin’s view, or something more carefully controlled in MacLean’s and Jesse’s. Jesse would like to see the drugs administered by trained guides working in what he calls “longitudinal multigenerational contexts,” which, as he describes them, sound a lot like churches. (Think of the churches that use ayahuasca in a ritual context, administered by experienced elders in a group setting.) Others envision a time when people seeking a psychedelic experience—whether for reasons of mental health or spiritual seeking or simple curiosity—could go, very occasionally, to something like a “mental health club,” as Julie Holland, a psychiatrist who used to work with Stephen Ross at Bellevue, described it. “Sort of like a cross between a spa/retreat and a gym, where people can experience psychedelics in a safe, supportive environment.”*

Everyone speaks of the importance of well-trained psychedelic guides—“board certified”—and the need to help people afterward integrate the powerful experiences they have had in order to make sense of them and render them truly useful. Tony Bossis paraphrases the religious scholar (and Good Friday Experiment volunteer) Huston Smith on this point: “A spiritual experience does not by itself make a spiritual life.” Integration is essential to making sense of the experience, whether in or out of the medical context. Or else it remains just a drug experience.

As for the guides themselves, they are already being trained and certified: late in 2016, the California Institute of Integral Studies graduated its first class of forty-two psychedelic therapists. (This is a development that worries some in the underground, who fear being left behind when psychedelic therapy is legitimized. Yet it’s hard to imagine such experienced and highly skilled practitioners won’t continue to find clients, especially among the well.)

When I asked Rick Doblin if he worries about another backlash, he pointed out that our culture has come a long way from the 1960s and has shown a remarkable ability to digest a great many of the cultural novelties first cooked up during that era.

“That was a very different time. People wouldn’t even talk about cancer or death then. Women were tranquilized to give birth; men weren’t allowed in the delivery room! Yoga and meditation were totally weird. Now mindfulness is mainstream and everyone does yoga, and there are birthing centers and hospices all over. We’ve integrated all these things into our culture. And now I think we’re ready to integrate psychedelics.”

Doblin points out that many of the people now in charge of our institutions are of a generation well acquainted with these molecules. This, he suggests, is the true legacy of Timothy Leary. It’s all well and good for today’s researchers to disdain his “antics” and blame him for derailing the first wave of research, and yet, as Doblin points out with a smile, “there would be no second wave if Leary hadn’t turned on a whole generation.” Indeed. Consider the case of Paul Summergrad, who has spoken publicly of his own youthful use of psychedelics. In a videotaped interview with Ram Dass that was shown at the 2015 meeting of the American Psychiatric Association, he told his colleagues that an acid trip he took in college had been formative in his intellectual development. (Jeffrey Lieberman, another past president of the American Psychiatric Association, has also written of the insights gleaned from his youthful experiments with LSD.*)

And yet, and yet . . . As much as I want to believe Doblin’s sunny forecast, it’s not hard to imagine things easily going off the rails. Tony Bossis agrees, as much as he hopes that psychedelics will someday be routine in palliative care.

“We don’t die well in America. Ask people where do you want to die, and they will tell you, at home with their loved ones. But most of us die in an ICU. The biggest taboo in America is the conversation about death. Sure, it’s gotten better; now we have hospices, which didn’t exist not so long ago. But to a doctor, it’s still an insult to let a patient go.” In his view, psychedelics have the potential not only to open up that difficult conversation but to change the experience of dying itself. If the medical community will embrace them.

“This culture has a fear of death, a fear of transcendence, and a fear of the unknown, all of which are embodied in this work.” Psychedelics may by their very nature be too disruptive for our institutions ever to embrace them. Institutions generally like to mediate the individual’s access to authority of whatever kind—whether medical or spiritual—whereas the psychedelic experience offers something akin to direct revelation, making it inherently antinomian. And yet some cultures have successfully devised ritual forms to contain and harness the Dionysian energies of psychedelics; think of the Eleusinian mysteries of ancient Greece or the shamanic ceremonies surrounding peyote or ayahuasca in the Americas today. It is not impossible.

The first time I raised Jesse’s idea of the betterment of well people with Roland Griffiths, he seemed to squirm a bit in his chair and then chose his words with care. “Culturally right now, that is a dangerous idea to promote.” And yet, as we’ve talked, now over the course of three years, it’s become clear that he too feels that many of us, and not just those dealing with cancer or depression or addiction, stand to benefit from these remarkable molecules and, even more, from the spiritual experiences to which he believes—indeed, his research has demonstrated—they can open a door.

“We’re all dealing with death,” as he told me the first time we met. “This is far too valuable to limit to sick people.” A careful man, mindful of the political land mines that may yet lie ahead, Griffiths amended that last sentence just slightly, recast it in the future tense: “This will be far too valuable to limit to sick people.”

• • • I, FOR ONE, sincerely hope that the kinds of experiences I’ve had on psychedelics will not be limited to sick people and will someday become more widely available. Does that mean I think these drugs should simply be legalized? Not exactly. It is true I had a very positive experience using psilocybin “recreationally”—on my own, that is, without the support of a guide—and for some people this might be fine. But sooner or later, it seems, everyone has a trip for which “bad” is far too pallid a modifier. I would hate to be alone when that happens. For me, working one-on-one with an experienced guide in a safe place removed from my everyday life turned out to be the ideal way to explore psychedelics. Yet there are other ways to structure the psychedelic journey—to provide a safe container for its potentially overwhelming energies. Ayahuasca and peyote are typically used in a group, with the leader, often but not necessarily a shaman, acting in a supervisory role and helping people to navigate and interpret their experiences. But whether individually or in a group, the presence of someone with training and experience who can “hold the space”—to use that hoary New Age locution—is more meaningful and comforting than I would have imagined.