Preface Suicide. The word suicide is captivating. When I was only seven years old, my grandfather, recently diagnosed with chronic obstructive pulmonary disease (COPD) and given oxygen to live on, placed a shotgun to his chest and took his life. Just like that, he was gone through a single decision. At that age, I could not process what was going on and why someone would want to take their own life. My father explained that my grandfather was a Native American (he was born on a reservation), and he believed that it was better to take his own life than to exist unnaturally. Certainly, too much for a seven-year-old to process. I have thought about my grandfather''s suicide just about every day since.

I witnessed how the ordeal affected my father and even more my grandmother. Later in my medical training, I discovered that tens of millions of others had been touched by suicide and the mental health crisis. Finally, when I was in private practice in Las Vegas, Nevada, I had five physician colleagues whose sons and daughters had all committed suicide before the age of eighteen. This struck me profoundly, and I have been a suicide prevention advocate ever since. When most people think about suicide, they don''t imagine a young child taking their own life. Suicide is the stuff of other people''s nightmares. A mother losing her child to suicide is horrific, and the reality of that grief is insurmountable. No amount of therapy can make sense of what just happened or assuage the unimaginable pain.

Time stops. The event continually replays in your head, leaving you wondering what you could have done differently. Getting support of any kind is a first step. A mental health provider can offer therapy, medications, and support groups. Most never see it coming. The subtle signs of mental illness often become apparent only after the fact. These signs are even more challenging to see in a young child. In 2020, eighteen students committed suicide in Las Vegas, more than one hundred adolescents jumped from the Golden Gate Bridge in San Francisco, 228 US police officers committed suicide, and Hayden Hunstable took his own life just four days before his thirteenth birthday.

Then there is the isolated case of Drew Robinson, a major league baseball player who thankfully survived his suicide attempt. The COVID lockdowns were gasoline to the fire that is the existing mental-health crisis. More adults and adolescents are depressed than ever. While suicides during the lockdowns did not increase as many thought they would, the resulting increase in mental illness is undeniable. Worldwide, about 1 million people go through with the act and ultimately die each year. Suicidal ideation is truly a hijacking of our brains, telling us to end our lives prematurely. What if there were a way to radically alter this hijacking device and grant the person in pain time to work things out, perhaps even losing the desire to take their own life? Ketamine is the one drug we have available to us today that can stop suicide in its tracks. Most have never heard of ketamine and, even among those who have, few know it could be used for seriously impacting the rate of suicide.

Ketamine is not the final answer in ending suicide, but it is one very significant tool we have that can change the course of a never-ending scourge. After reading this book, you will fully understand what suicide is, possible steps for prevention, and its devastating cost to our society. To those who say more studies are needed to know if ketamine helps with suicide and depression, I offer you this admonition: if you are that person suffering from depression and suicide, the risk versus reward is clearly in favor of using ketamine now. This book brings together many aspects of the mental-health crisis, suicidality, and how ketamine can help. Throughout this book, you will encounter many stories about suicide, mental health, addiction, and how ketamine changed the course. Ketamine has been safely used for over seventy years. There are scores of publications about ketamine; about 6,500 papers exist in the Medline/PubMed database. Today, these findings and data may be at their most important as the world we live in continues to lose its bet to suicide.

This book is dedicated to the invisible lives lost by suicide.