Dr. Nico Grundmann used ketamine as an emergency physician long before he co-founded Ember Health, which runs IV ketamine clinics in New York. Mark “Moose” McGrath and I sat down with him in Manhattan to talk about how the treatment works for people living with depression, PTSD and suicidal thoughts, especially veterans and first responders. Ember Health is a sponsor of No Way Out.
Nico describes depression as a stress and trauma driven loss of connections in the brain’s emotional regulation circuits. He explains how a series of four infusions over two weeks aims to regrow those connections. The goal he describes is alignment. Joy returns when life warrants it, and grief shows up when it should.
The window after each session
Nico talks about the period after each infusion, when he says therapy becomes easier and more effective. Ember pairs ketamine with therapy to use that window, so people can integrate what they learn and keep the change. He treats maintenance sessions as a normal part of care.
The hard questions
We take on safety, misuse and the gap between clinical dosing and recreational use. Nico explains why benzodiazepines can blunt the benefit, who should avoid treatment, including people with schizophrenia, and how ketamine compares with SSRIs and alcohol. We also cover access. The VA offers IV ketamine in many states, some insurers now cover it, and clinics can help with out-of-network reimbursement.
Why the stigma lasts
In 2022 and 2023, when I was at the Pentagon, I asked people in the VA to look at these treatments. As I see it, two things hold them back. One is a culture shaped by the war on drugs. The other is a system with little money to make from a healthy patient. Orientation sits at the center of John Boyd’s real OODA loop, and stigma is orientation at work. It shapes what a veteran believes is possible before he ever walks into a clinic.
This episode is not medical advice. If you are a veteran in crisis, call 988 and press 1, or text 838255. Anyone else can call or text 988.
What would it take for you to look again at a treatment you once dismissed?
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Written by Ponch Rivera with AI assistance in production. The full conversation is in the player below.