This month, we celebrate Innerbloom’s two-year anniversary. I want to take a moment to reflect on our journey—how we became the first and only ketamine and psychedelic clinic in San Luis Obispo. From treating our first patient (while I was still working full-time as a trauma surgeon) it’s remarkable to look back on the evolution of Innerbloom and the lives that have been transformed, including my own, through the power of ketamine therapy. With immense gratitude, I acknowledge the serendipitous turns of events, key individuals, and the unwavering support from our community, family and friends that have made this practice possible. Join me as I share the story of how Innerbloom blossomed from an idea into a fully-fledged practice—one that I have poured my heart into and now consider my true calling; having transitioned careers to dedicate myself entirely to offering ketamine therapy as both my profession and passion.
The physical and mental demands of working as a trauma surgeon became exponentially more challenging during and after the pandemic. Like many of my colleagues, I felt burned out—overworked, exhausted, and deeply unhappy. My role as a trauma surgeon required 24-hour, sometimes 48-hour, consecutive shifts, leaving me spending more time inside the hospital than out. As one might expect, this strain took a serious toll on my mental health, which spilled over into my personal life and impacted my relationship with my now ex-wife.
Without delving too deeply into the details, my ex-wife filed for divorce. This came as a shock and sent me spiraling into a deep depression. After hitting some new lows, I knew something had to change—I needed to take action. I began to research my options and I soon discovered that ketamine, a medicine I had used often at the hospital, was being used in low doses, off-label, for the treatment of depression. The idea that this treatment could offer relief without the potential side effects and the long-term daily use associated with conventional antidepressants made ketamine therapy a key option worth pursuing.
Admittedly, I was skeptical at first, but after my very first infusion, I distinctly remember feeling a sensation of hope—a feeling I had long forgotten. It was as if a dark cloud had lifted, and I could see that my trauma did not define me. Instead, I realized I possessed the ability to change my mind and my situation. And change, I did.
I began taking better care of my physical and mental health. I became more compassionate toward myself and acutely aware of the way in which I spoke to myself, closely monitoring my negative thought pattern and behaviors. I began to feel better. The shift became profound. I knew I wanted to help others experience the transformative power of ketamine therapy. Driven by this newfound passion, I immersed myself in learning everything I possibly could about ketamine therapy. I spent countless hours reading literature, taking courses, attending conferences, and seeking out mentors who could guide me in starting a safe and effective ketamine therapy practice in my beloved community of San Luis Obispo.
Eventually, I opened the doors of Innerbloom and began seeing patients on my days off from the hospital. But then something unexpected began to happen. As a surgeon, I had become incredibly skilled at compartmentalizing the horrific things I witnessed everyday at work. But after starting at Innerbloom, my perception of my surgical patients began to change. No longer were they merely a number on a chart, just cases of gunshots, car accidents, appendicitis, or colon cancer—they became actual individuals in my community. Real people with struggles, families, and loved ones who cared for them deeply.
It became increasingly difficult for me to do my job as a trauma surgeon without being profoundly affected by the person behind the trauma. I felt their pain, their anxiety, and I started to worry that this newfound sensitivity might hinder my ability to perform my job with the necessary objectivity and efficiency required of a trauma surgeon. The reality is that to be a great trauma surgeon, you must be unaffected by witnessing immense pain and loss frequently and, even more challenging, seeing the very worst of humanity when people inflict unspeakable violence upon one another.
It became clear that a significant change had occurred in my psyche, and I realized I needed to leave my career as a surgeon behind. I wanted to focus entirely on this new practice. I was determined that if I were going to make this transition, I would do it right— building a clinic I could be proud of, one rooted in the highest quality care and backed by evidence-based practice.
With the help of a close friend and business advisor, I was soon able to open our doors. At first, Innerbloom was just a two-person team. Through a twist of fate and mutual friends, I was introduced to a nurse named Emerald who owns a local laser and aesthetics clinic. Like me, Emerald was passionate about the potential of psychedelic medicine to treat mental health, and as a small business owner herself, she understood the challenges I faced. As luck would have it, she not only offered me the opportunity to lease a room from her business, but she also wanted to help me get started. Her role included assisting with IV insertions and occasionally sitting with patients during infusions.
Over time, the practice evolved into what it is today, now including a team of two ketamine-assisted psychotherapists, Cindy and Alisa, our clinic manager and my soon-to-be wife, Libby, and our therapy Golden Retriever, Eli. While my roles have shifted and, in may ways, expanded, I personally insert all the IVs and sit with patients during every infusion. I consider it a privilege to hold space for my patients and find it immensely rewarding to share these transformative experiences with them.
I quickly recognized that many individuals considering ketamine therapy have already exhausted a variety of other treatment modalities, including pharmaceuticals, therapies like Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), or more invasive procedures such as Electroconvulsive Therapy (ECT). I also realized that there is considerable variation in approaches among other providers offering ketamine therapy. While some clinics focus solely on symptom alleviation through ketamine infusions using a medical model, I believe a more effective approach is to adopt a holistic perspective. By involving mental health providers, we can use ketamine therapy as catalyst for meaningful changes in perception and behavior, rather than merely treating ketamine as an antidepressant. As an active member of the American Society of Ketamine Physicians Psychotherapists & Practitioners (ASKP), a non-profit group of professionals dedicated to the safe clinical use of ketamine for mental health disorders and pain conditions, I hold myself to highest standard of collaborative care.
Patients who undergo treatment with us are encouraged to incorporate psychotherapy that works synergistically with the medicine. We ask patients to meet with our certified ketamine-assisted psychotherapist, Cindy Nelson, LMFT for a minimum of three sessions. I find it essential to offer collaborative care, recognizing that the path to healing often requires a team approach. We have made significant efforts to collaborate with other medical and mental health providers in the community as well. Consequently, a significant part of my role involves hosting supportive gatherings at Innerbloom, engaging in educational opportunities, and participating in community outreach experiences.
My ultimate goal with Innerbloom has been to provide patients with all the necessary elements to give them the best chance of achieving not only a robust response but also sustaining it over time.
It has been an incredible journey so far, and I recognize that ketamine and psychedelic-assisted therapy is a rapidly evolving field. Staying current with the latest research and drawing on the expertise of others is crucial as we continue to strive for improvement. Education is a cornerstone of my practice in this field of medicine, and I continue to learn each day in order to provide the best possible care for my patients. While it’s humbling to reflect on our beginnings, it’s even more exciting to envision what lies ahead in the coming years. With deep gratitude, I thank everyone for their support, especially those who helped turn the vision of Innerbloom into a reality. Here’s to two years of Innerbloom and many more to come!
About the Author
Dr. Ray Rivas, a former general and trauma surgeon with over a decade of experience utilizing ketamine, became a ketamine therapy specialist to treat mental health and pain after witnessing its profound impact on his hospital trauma patients and his own mental health. As the founder and medical director of Innerbloom Ketamine Therapy in San Luis Obispo, California, Dr. Rivas applies his extensive medical expertise to provide safe, evidence-based ketamine treatments for mood disorders, including depression, anxiety, PTSD, and chronic pain. His passion lies in helping patients find relief and rediscover hope through personalized, compassionate care.
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