Under the Needle: The lesson that Ketamine, Tattoos, and a Sea Turtle taught me about recovery and love.

By Josh Cutler

“I didn’t wake up this morning thinking I was going to get a tattoo,” I moaned through gritted teeth.  Surrounded by a symphony of tattoo needles in a busy parlor in Los Angeles, I was starting to feel homesick for the rain of Seattle, despite the incredible sunshine here.  

The heavily tattooed woman with red hair who was pushing the needle into my chest chuckled and said, “That’s the beginning to a lot of really good stories.”  I couldn’t help but smile under my mask, despite the periodic bursts of pain searing into my flesh.  “Almost done with the outline, then time for shading,” my SF tattoo artist said matter-of-factly.  

My hands gripped the table and I tried to practice my meditative breathing techniques, but I was far from relaxed.  “Leo!”  I yelled, my twenty four year old 6’4” nephew’s head popping up from his slumped position in the lobby.  “Take a few pictures, will you?”  I inhaled, gritting my teeth and trying not to complain about this pain I had signed up willingly, even enthusiastically for, just a few minutes before.  

At forty, here I was, in the state of my birth, getting my first tattoo.  This had definitely not been on the itinerary for this trip, but as I sat in the chair with that needle burning into my skin, I realized there was certainly something preordained about this rite of passage.  Ninety minutes later the pain had turned to a cathartic calm and I was sleepy.  The tattoo artist covered my tattoo in a clear bandage and told me to leave it on for a few days to heal, as it was an open wound.  

The next day, on my flight home to Seattle, and in the weeks to follow, I felt a distinct pain on my chest where I had been inked.  The elation of this trip led to a bit of a crash, mood-wise, when I returned home, where I went into hibernation mode through the Thanksgiving holiday.  I wondered if getting this tattoo was totally silly and impulsive and a bit too permanent.  And then my wife sent me an article from the local paper, and it all made sense.

A sea turtle was recently found on the coast of Washington State by a tribal member there.  These large animals are not native to the area, far from it.  The turtle and its oversized shell had been carried thousands of miles north, likely from the tropics of Mexico, to the frigid Pacific Northwest shoreline.  The turtle was transported to the Seattle Aquarium, where it is receiving emergency care.  A turtle like this is usually several pounds heavier and has a heartbeat of around 14 beats per minute.  This turtle’s heart was beating one time per minute.  They named her Shi Shi (pronounced She She) and slowly worked on rehabilitating her.  

A key part of the process was bringing her temperature back to its natural setting, but they had to go slow — only one degree every few hours or it might shock her fragile system.  At the time of my writing this, Shi Shi is clinging to life, far from home, after her world was ravaged by storms that threw her life way off course.  I’ve been thinking a lot about Shi Shi since I read that article in the Seattle Times.

The sea turtle, known as a symbol for wisdom and longevity, has been an important symbol in my life lately.  I recently kindled a spiritual connection to the animal as part of my own recovery from serious illness.  I suppose Shi Shi’s slow and steady recovery is a good metaphor for me.  I am so restless to be “better,” to be “healed,” to be “100%” — but these dualistic black and white reductions of recovery can in no way capture what I am going through.  I am forever changed.

As part of my recovery from a serious bout of clinical depression I started ketamine infusions a few months ago.  I had stabilized since my week in the day psychiatric hospital, a year prior, but I was still really struggling to keep my head above water.  I was exhausted all the time, burned and stressed out with work, not sleeping well, and irritable with my family.  But I was functional.  My heart was beating.

Ketamine, a Vietnam-era anesthetic, is relatively safe and has shown promise for treating depression and chronic pain.  A friend recommended it based on her own experience treating chronic pain and escaping the hell of opiate dependence.  A referral from my doctor and an intake with an anesthesiologist later, I had an IV in my arm and was hooked up to a ketamine drip.  

The nurse offered me a warm blanket and I slipped my AirPods into my ear and pressed play on my favorite Enya album.  The nurse turned off the lights and left the room, a large projected underwater scene on the wall.  The doctor had told me I would feel a “floaty” feeling when I got to the right dose.  The first session I honestly didn’t feel a lot for most of it, besides groggy from the Benadryl and Zophran that they gave me for anxiety.  But near the end, when the nurse upped my dose for the last time, I felt something kick in.  I was suddenly bathed in light and felt absolute love permeate my being.

It was the second infusion where things got really interesting.  I was starting to feel floaty and watching the fishes swim by, tapping my toes to the familiar tones of Enya, when a sea turtle appeared.  The big brown shell moved gracefully through the water and I followed.  A familiar feeling washed over me, one that I had not felt in many years.  Dad!!!!  This was Dad!  My beloved dad, Sandi Cutler, had died suddenly of a heart attack a few years prior, and I still grieved him, intensely at times.  But here he was, his energy anyway, clearly guiding me through the ocean.  We swam together for what felt like hours.  I felt safe and relaxed, more than I had in years.  I felt my secure attachment to this being I loved so much.  I felt at home, like he had created this whole ocean, just for us to roam together.

Beeping started from the IV pole behind me and the nurse appeared at the door to unhook me.  I looked at her, with tears in my eyes and said “it all makes sense now.”  I have no idea what it meant, but I knew how it felt.  It was totally the opposite of the icy, solitary, terror of depression.  I felt connected, I felt loved.

In the coming months I had a number of additional ketamine infusions, but that one was certainly the most spiritual.  In other sessions I cried and cried, finally deeply grieving the loss of the living Sandi in my life, but finally able to connect to his immutable spirit once more, through the Sea Turtle, with a little help from psychedelic medicine.

On a whim during a recent trip to LA to hang out with my rockstar nephew and attend a ketamine assisted psychotherapy training, my nephew and I decided to get tattoos.  We were at a diner and he offered to buy breakfast if I bought the tattoos.  I had never had any interest in having a tattoo but now I knew that I wanted a sea turtle etched into my skin.  I knew now that my dad Sandi was always with me and I wanted a daily reminder.  Our heavily tattooed waitress directed us to a parlor on the other side of Hollywood and we set out to get inked, laughing at the crazy impulsiveness of our plan.  A couple hours later I stood shirtless in that tattoo parlor smiling.  Above my heart, there was a tattoo of a sea turtle, with a flowering shell that has a heart at its center.

Back at home, as I read the story about Shi Shi the sea turtle’s harrowing journey, from the tropical coast of Baja California to the frigid one of Washington, I felt a deep connection.  For one, I had been tattooed around the time that Shi Shi was found, totally unbeknownst to me, as it was weeks later, when my tattoo finally healed, that I read about it in the paper.

As my tattoo healed, a brief bout of depression, or maybe intense grief had also hit.  The day of my Dad’s birthday I could barely get off the couch.  But then I read about Shi Shi and it all made sense.  It takes time to recover from storms that toss us into frigid waters, far from the familiar.

Recovery is slow; we can’t rush it.  But if we pay attention, and keep swimming, we will no doubt encounter the love that is always all around us, waiting for us to wake up and notice.


Josh Cutler, MSW, LCSW is a psychotherapist, licensed clinical social worker, and mental health leader.  He is the author of The Day Hospital: A Memoir, including Hello Lithium, My Old Friend and other essays on recovery.  He lives in the Pacific Northwest with his family.