In the midst of the pandemic, a 35 year old man I’ll call Sav, began shooting hoops in his hometown in Italy. First, he shot from the three point line. Then, he turned around and shot backward, sinking the basketball into the net. A few weeks later, he did it blindfolded. Then backward, blindfolded, and while jumping on a trampoline. 

The trick shot obsession grew to kicking ping pong balls into narrow-mouthed water jugs and launching soccer balls into basketball hoops with a golf club. In less than a year, he amassed millions of followers and cashed fat checks from merch and ad sales. 

Then, in the summer of 2022, Sav went dark. 

As it turns out, the followers, the money, the trick shots—all of it was a result of psychiatric drug withdrawal-induced akathisia, a constant state of tortuous restlessness and burning agitation that Sav described as “dishumane.” Unable to sleep or stop moving, Sav channeled his distress into intricate human tricks.

The circus nature of it all kept him occupied in between months long hospitalizations over 30 sessions of controversial electroconvulsive therapy (ECT). He spoke to every known doctor, expert, and advocate on the subject of withdrawal—including me—in hopes that someone could stop the pain. Nothing helped. Most suggestions just made things worse.

Today, Sav is in the process of ending his life through an assisted suicide organization in Switzerland. 

There is an aphorism in medicine, coined by former Dean of Medicine at Harvard Dr. Charles Sidney Burwell that says, “Half of what we are going to teach you is wrong, and half of it is right. Our problem is that we don’t know which half is which.”

I think about this quote constantly, both in the context of my own health and when people like Sav reach out to me for help. I can’t give medical advice since I’m not a doctor, but I can talk about my experience and share resources. Even when I’m passing along research done by other people, it’s a paralyzing to know how much we don’t know, how much I don’t know. What works for one person causes havoc in another. That’s all well and good if the body is strong enough to recover from all the self experimentation. But in a case like Sav’s, any little change seems to set off a cascade of irreversible negative effects.

So much of medicine, and especially a new field like psychiatric drug withdrawal, is focused on the how, not the why. The why is too expensive, requiring oodles of money and serious research. Sav’s case is the perfect example. He followed the leading theory of tapering off psychiatric drugs—hyperbolic tapering—a strategy that encourages small dose reductions, each one smaller than the one before, over a long period of time. Research shows that generally, this method lessens or eliminates withdrawal symptoms by allowing the brain and body to adjust without getting overwhelmed by the sudden lack of drug presence.

But there is a subset of people like Sav who don’t seem to tolerate this method. Instead, it’s like their body hits a limit with how much of the drug they can process, and these long tapers basically become prolonged poisoning. Sav told his doctors over and over again that he thought the taper was hurting him. He was dismissed and told to stay the course. Not knowing what else to do, he followed their advice. And he’s now going to Switzerland because of it.

I’ve heard similar stories from enough people to know that Sav’s story is not a one off. For these folks, there’s something going on physiologically that’s outside of the norm. My hunch is that it has something to do with the genetic component of their body’s CYP system, a complex bodily function involved in the metabolism of drugs, chemicals, hormones, and neurotransmitters. But until someone designs a study for people in withdrawal that analyzes genetic variants in the CYP system, it’s all just a guess. And I’m sure it’s not that simple. I’d also like to see fMRIs, qEEG, hormone panels, and VO2 max tests for people in withdrawal. Until that actually happens (if it ever happens), people like Sav are going to suffer thanks to well intended but myopic views.

Personally, I don’t know know how to deal with this. I’m heartbroken over Sav. I feel like the community failed him. It’s an impossible position for everyone. What percentage of people are sacrificial lambs on the path to truth and understanding? How do you instill hope in the hopeless? How do you help when sometimes the help is poison?

If there is any silver lining to this story, it is this: Sav told me he does not want to go quietly. He wants the world to know his story. We have a little bit of time. The checks and balances in Switzerland are many, for good reason, and he does not yet have a date.

Of course, I hope that between now and then some miracle shows up and he finds some relief. If not, I have to assume that he is a player in a bigger game. That somehow, his suffering won’t be in vain because it will lead to more awareness and education. He is, after all, a bit of a showman. Every trick shot sunk not just to distract himself, but to prove that nothing is impossible.

I will share his real name when he is ready to fully go public. In the meantime, he has given me permission to share his story. Thank you for reading.