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EVERY PSYCHEDELIC JOURNEY is different, yet a few common themes seem to recur in the journeys of those struggling with cancer. Many of the cancer patients I interviewed described an experience of either giving birth or being reborn, though none quite as intense as Patrick’s. Many also described an encounter with their cancer (or their fear of it) that had the effect of shrinking its power over them. I mentioned earlier the experience of Dinah Bazer, a petite and mild New Yorker in her sixties, a figure-skating instructor, who was diagnosed with ovarian cancer in 2010. When we met in the NYU treatment room, Dinah, who has auburn curls and wore large hoop earrings, told me that even after a successful course of chemotherapy she was paralyzed by the fear of a recurrence and wasted her days “waiting for the other shoe to drop.”

She too worked with Tony Bossis and in the difficult first moments of her session imagined herself trapped in the hold of a ship, rocking back and forth, consumed by fear. “I stuck my hand out from under the blanket and said, ‘I am so scared.’ Tony took my hand and told me to just go with it. His hand became my anchor.

“I saw my fear. Almost as in a dream, my fear was located under my rib cage on the left side; it was not my tumor, but it was this black thing in my body. And it made me immensely angry; I was enraged by my fear. I screamed, ‘Get the fuck out! I won’t be eaten alive.’ And you know what? It was gone! It went away. I drove it away with my anger.” Dinah reports that years later it hasn’t returned. “The cancer is something completely out of my control, but the fear, I realized, is not.”

Dinah’s epiphany gave way to feelings of “overwhelming love” as her thoughts turned from her fear to her children. She told me she was and remains a “solid atheist,” and yet “the phrase that I used—which I hate to use but it’s the only way to describe it—is that I felt ‘bathed in God’s love.’” Paradox is a hallmark of the mystical experience, and the contradiction between the divine love Dinah felt and “not having a shred of belief” didn’t seem to faze her. When I pointed this out, she shrugged and then smiled: “What other way is there to express it?”

Not surprisingly, visions of death loom large in the journeys taken by the cancer patients I interviewed at NYU and Hopkins. A breast cancer survivor in her sixties (who asked to remain anonymous) described zipping merrily through space as if in a video game until she arrived smack at the wall of a crematorium and realized, with a fright, “I’ve died and now I’m going to be cremated. (But I didn’t have the experience of burning—how could I? I was dead!) The next thing I know, I’m belowground in this gorgeous forest, deep woods, loamy and brown. There are roots all around me and I’m seeing the trees growing, and I’m part of them. I had died but I was there in the ground with all these roots and it didn’t feel sad or happy, just natural, contented, peaceful. I wasn’t gone. I was part of the earth.”

Several cancer patients described edging up to the precipice of death and looking over to the other side before drawing back. Tammy Burgess, diagnosed with ovarian cancer at fifty-five, found herself peering across “the great plane of consciousness. It was very serene and beautiful. I felt alone, but I could reach out and touch anyone I’d ever known.

“When my time came, that’s where my life would go once it left me, and that was okay.”

The uncanny authority of the psychedelic experience might help explain why so many cancer patients in the trials reported that their fear of death had lifted or at least abated: they had stared directly at death and come to know something about it, in a kind of dress rehearsal. “A high-dose psychedelic experience is death practice,” says Katherine MacLean, the former Hopkins psychologist. “You’re losing everything you know to be real, letting go of your ego and your body, and that process can feel like dying.” And yet the experience brings the comforting news that there is something on the other side of that death—whether it is the “great plane of consciousness” or one’s ashes underground being taken up by the roots of trees—and some abiding, disembodied intelligence to somehow know it. “Now I am aware that there is a whole other ‘reality,’” one NYU volunteer told a researcher a few months after her journey. “Compared to other people, it is like I know another language.”

At a follow-up session with Tony Bossis a few weeks after his journey, Patrick Mettes—whom his wife, Lisa, describes as “an earthy, connected person, a doer”—discussed the idea of an afterlife. Bossis’s notes indicate that Patrick interpreted his journey as “pretty clearly a window . . . [on] a kind of afterlife, something beyond this physical body.” He spoke of “the plane of existence of love” as “infinite.” In subsequent sessions, Patrick talked about his body and cancer “as [a] type of illusion.” It also became clear that, psychologically at least, Patrick was doing remarkably well in the aftermath of his session. He was meditating regularly, felt he had become better able to live in the present, and “described loving [his] wife even more.” In a session in March, two months out from his journey, Bossis noted that Patrick, though slowly dying of cancer, “feels the happiest in his life.”

“I am the luckiest man on earth.”

• • • HOW MUCH SHOULD THE AUTHENTICITY of these experiences concern us? Most of the therapists involved in the research take a scrupulously pragmatic view of the question. They’re fixed on relieving their patients’ suffering and exhibit scant interest in metaphysical theories or questions of truth. “That’s above my pay grade,” Tony Bossis said with a shrug when I asked him whether he thought the experiences of cosmic consciousness described by his patients were fictive or real. Asked the same question, Bill Richards cited William James, who suggested we judge the mystical experience not by its veracity, which is unknowable, but by “its fruits”: Does it turn someone’s life in a positive direction?

Many researchers acknowledge that a strong placebo effect may be at work when a drug as suggestible as psilocybin is administered by medical professionals with legal and institutional sanction: under such conditions, the expectations of the therapist are much more likely to be fulfilled by the patient. (And bad trips are much less likely to occur.) Here we bump into one of the richer paradoxes of the psilocybin trials: while it succeeds in no small part because it has the sanction and authority of science, its effectiveness seems to depend on a mystical experience that leaves people convinced there is more to this world than science can explain. Science is being used to validate an experience that would appear to undermine the scientific perspective in what might be called White-Coat Shamanism.

Are questions of truth important, if the therapy helps people who are suffering? I had difficulty finding anyone involved in the research who was troubled by such questions. David Nichols, the retired Purdue University chemist and pharmacologist who founded the Heffter Research Institute in 1993 to support psychedelic research (including the trials at Hopkins, for which he synthesized the psilocybin), puts the pragmatic case most baldly. In a 2014 interview with Science magazine, he said, “If it gives them peace, if it helps people to die peacefully with their friends and their family at their side, I don’t care if it’s real or an illusion.”

For his part, Roland Griffiths acknowledges that “authenticity is a scientific question not yet answered. All we have to go by is the phenomenology”—that is, what people tell us about their internal experiences. That’s when he began querying me about my own spiritual development, which I confessed was still fairly rudimentary; I told him my worldview has always been staunchly materialist.