Learning to Die: Psilocybin at the End of a Terminal Diagnosis

The fear was not of death, exactly. It was of the approach to death — the loss of function, the dependence, the witnessing of my family's grief while I was still present to witness it. I had spent four months since my diagnosis keeping the fear managed, which meant keeping it contained, which meant it was running everything from behind a wall.

My palliative care team had experience with psilocybin-assisted therapy for cancer anxiety. I applied and was accepted. The preparation sessions were themselves valuable — the first time I had spoken about the fear directly rather than managing it.

The session opened something I had been keeping closed. I am not going to describe what I saw or felt in detail because it belongs to me and also because I'm not sure language can reach it. What I can say is that the fear transformed during the session — not disappeared, but changed from something I was holding away from me to something I was in relationship with.

I am still dying. The timeline hasn't changed. What has changed is that the fear no longer runs me from behind the wall. I can look at it. I can have the conversations I need to have with my family. I can be present in whatever time I have. That, for me, was everything.