Atrial fibrillation

Atrial fibrillation is the heart-rhythm condition that interrupts the narrator’s preparations for psychedelic experiences and turns an abstract concern about safety into a recurring, closely monitored bodily fact. First diagnosed after a sudden irregular heartbeat, it leads to medication, persistent attention to the heart, and a consultation with a cardiologist before the narrator’s planned drug experiences. When the rhythm appears again after a demanding breathwork session, the narrator must weigh fear and uncertainty against the wish to continue. The condition does not simply cancel the journey: it changes how the decision is made, including a reduced LSD dose and an agreement to seek emergency help if necessary.

Diagnosis and Vigilance

A year before embarking on the planned experiences, the narrator was sitting at a computer when a pronounced, erratic rhythm became noticeable in the chest. An electrocardiogram showed abnormal traces, and the doctor identified the condition as atrial fibrillation. The doctor explained that the immediate concern was not a heart attack but an increased risk of stroke. The narrator was prescribed medication to steady the rhythm and lower blood pressure, as well as a daily low-dose aspirin to thin the blood. The reassurance to avoid worrying did not have the intended effect.

Instead, the diagnosis made a bodily process that had previously gone unnoticed into an object of near-constant attention. The narrator checked blood pressure daily and listened for irregularity at bedtime. Although the atrial fibrillation did not recur for months, the possibility of another episode remained present in ordinary routines. Only after months without a stroke did the narrator gradually begin to trust the heart to function without constant supervision. In this account, the diagnosis matters both as a medical assessment and as a shift in attention: the heart becomes newly salient precisely because it had formerly operated outside conscious awareness.

Consultation Before the Journey

The narrator’s decision to consult a cardiologist before taking psychedelic drugs follows directly from that history. The intended journey was no longer a question of curiosity alone; it required considering the diagnosed rhythm disturbance and the medications prescribed for it. The cardiologist reviewed the proposed substances and possible interactions. He was not especially concerned about most of the psychedelics discussed, which the narrator understood as acting primarily in the mind and having comparatively little effect on the cardiovascular system. He advised against MDMA, however, because its amphetamine chemistry implicated the heart differently.

That distinction shaped the available plan. The narrator was disappointed that MDMA was ruled out, but understood the cardiologist’s advice as permitting the other planned experiences. The consultation did not erase uncertainty or provide a blanket guarantee. Rather, it made medical assessment part of the preparation and separated one proposed substance from the others on cardiovascular grounds. The narrator’s account therefore presents bodily risk not as an abstract warning attached to all psychedelic use, but as a specific concern requiring attention to the individual’s health, medications, and intended substance.

Recurrence During Breathwork

The condition returned during a preparatory holotropic breathwork session with Fritz, a guide, in a remote location. After the session, Fritz had gone to prepare dinner while the narrator tried to record notes. The narrator felt the heart surge into a chaotic rhythm and recognized the sensation as resembling the earlier atrial fibrillation. Being a dozen miles from ordinary help intensified the practical stakes: the episode was happening away from the grid, before the planned LSD session, and the narrator did not know whether proceeding the next day would be safe.

The irregular rhythm continued for about two hours, through a quiet, anxious dinner. Fritz was concerned; in his experience leading or witnessing many breathwork sessions, he had not seen this reaction. He considered whether the sensation might have a psychological meaning, such as a heart opening, but the narrator resisted that interpretation and treated the heart as a malfunctioning pump. The contrast is central to the episode: the guide’s interpretive vocabulary could give the bodily event symbolic meaning, while the narrator held to its physiological character and the possibility of danger. The rhythm then returned as suddenly as it had begun.

A Changed Decision

That night, the narrator repeatedly considered abandoning the LSD journey. The heart felt normal again, but the episode had made the risk difficult to dismiss. The narrator reasoned that LSD’s effects were generally understood to be concentrated in the brain, with little direct cardiovascular impact, and also recognized in retrospect that breathwork had been physically arduous. Yet neither consideration resolved the question completely. The prospect of postponing the journey brought disappointment, because the narrator had come a long way and had found the altered state glimpsed during breathwork compelling.

By morning, the narrator decided to proceed, but not without changing the plan. At breakfast, the narrator told Fritz of the decision, and they agreed on a modest initial dose of one hundred micrograms, with the option of a further dose after an hour or two. The guide also asked the narrator to consider an intention while walking and preparing for the session. Before setting out, the narrator resolved to ask Fritz to promise that he would call emergency services if anything went wrong, regardless of personal risk. Atrial fibrillation thus altered the journey without determining its outcome: it produced consultation, hesitation, a more cautious dose, and an explicit safety agreement.

The Body as Part of the Psychedelic Setting

The episode also complicates any account of a psychedelic experience as something that happens only in the mind. The narrator’s heart condition shaped the setting before the LSD was taken, affected the relationship with the guide, and supplied a concrete limit against which the desire to explore had to be tested. The narrator had sought medical advice, yet the recurrence during breathwork showed that preparation could not make every bodily response predictable. The guide’s presence and the agreed emergency plan became consequential parts of the conditions under which the journey might proceed.

This practical emphasis fits the book’s wider account of psychedelic work as requiring a structured container rather than an unguided encounter. Preparation can include medical questions, attention to possible interactions, a considered intention, and arrangements for responding if something goes wrong. In the narrator’s case, those safeguards are not presented as a cure for atrial fibrillation or proof that the journey is risk-free. They are the means by which a real health concern remains visible in the decision: neither converted into a mystical metaphor nor used to erase the narrator’s wish to continue.