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two 0.6 mg/kg sessions that morning so that I could determine if this dose caused similar responses in two different people. 12. * PROLOGUE emptying the entire syringe full of DMT solution. While I believed 0.6 nig/kg most likely was physically safe, the potentially shattering mental effects loomed in front of all of us even more dramatically than they had before Nils's session. However, Philip was not to be outdone by his friend and fellow "psychonaut." He was ready for his 0.6 mg/kg dose. This tendency in our volunteers, to persevere even under the possi- bility of an annihilating psychedelic experience, was marked. It was most apparent during our tolerance study, which took place the next year, in 1991, in which volunteers received four large doses of DMT, each sepa- rated by only 30 minutes. Not one volunteer, no matter how worn out, refused that fourth and final high dose of DMT. Philip's desire to take the same dose as Nils confronted me with a scientific, personal, and ethical dilemma. My training had taught me that one should not shy away from prescribing a little too much of a medica- tion ifthe circumstances called for doing so. For example, very high doses might be necessary for a full therapeutic response in otherwise treatment- resistant patients. In addition, it was important to learn about toxic effects, to be able to recognize them quickly in various circumstances. This latter point is even more important when studying a new experimental drug. It was within my authority and responsibility as the principal investi- gator of the project to tell Philip I did not want him to repeat a Nils-like 0.6 mg/kg DMT experience. However, Nils seemed fine now. Most impor- tantly, he was the first and only person to get this dose. I had planned on I liked Philip, and he did want his 0.6 mg/kg dose. But how much of a role did our friendship play? I didn't want to do as he requested just so that I wouldn't jeopardize our relationship, but I wanted his participa- tion in this early stage of the study to be worth his while. He was, in some ways, "doing us a favor." Philip lived far from Albuquerque, and asking him to return once more to get 0.6 mg/kg, if 0.4 or 0.5 were not a full- enough dose, would have inconvenienced him. There were many competing priorities. I hoped I made the right decision by agreeing to give Philip 0.6 mg/kg.