Two people can receive the same ketamine dose and have very different experiences. Dr. Nico Grundmann and Tiffany Franke built Ember Health around that difference.
Nico is an emergency physician and a co-founder of Ember Health. Tiffany is its Chief Experience Officer. They are married, and this was our first conversation with a married couple. Ember Health is a sponsor of No Way Out, and Nico first joined us in Episode 139.
Nico covers the medical side. Ketamine has decades of use as an anesthetic. Ember doses by weight and monitors patients in the room. Each infusion runs about ninety minutes. He also explains why Ember requires a diagnosis from a third party and a live handoff from a therapist or psychiatrist before treatment starts.
Set and setting
Tiffany works on what researchers call set and setting, the mindset a patient brings and the room they sit in. She shows how language, space and therapeutic communication shape results, down to tea rituals and training clinicians to guide altered states with steadiness. Ember pairs infusions with therapy during the window afterward, when the brain is more open to change, to turn rapid relief into lasting change.
I see John Boyd’s implicit guidance and control in what Tiffany built. Orientation sits at the center of Boyd’s real OODA loop, and when orientation is sound, correct action comes without deliberation. At Ember, intake, environment, communication and the infusion itself are all designed.
Access
Nico and Tiffany share stories from their patients. A retiree feels joy after decades of depression. A mother could not wait weeks for an antidepressant to work. Adolescents get back to school. They also take on cost. Out-of-pocket barriers are real, so Ember is building the data case for insurance coverage with insurers, the VA, Medicare and employers.
This episode is not medical advice. Talk with a licensed clinician about any treatment.
What part of your own work depends more on the setting than on the tool?
Listen and watch:
YouTube:
Apple Podcasts:
Spotify:
No Way Out on YouTube:
https://youtube.com/@nowayoutpodcast
Written by Ponch Rivera with AI assistance in production. The full conversation is in the player below.