Before taking Hope's call, Mithoefer had spent nearly three years navigating the federal bureaucracy to win approval for his small experiment, designed to test a simple question: Is MDMA, used in a clinical setting, safe?
'I got to survive. But for what?'
As a teenager, Hope marched with a precocious sense of purpose. At age 13, she moved across the country to live with family friends in New Jersey.
A year later, she was back in California, where she found a full-time secretarial job while completing her high school coursework. She built a strong relationship with her father, who had separated from her mother when she was an infant.
By the time she was 17, she was back with her mom but supporting herself financially.
She was wary of relationships but wanted a family, and at 19 she found a like-minded colleague who agreed to co-parent a son. They moved to Hawaii, because she had fond memories of a childhood vacation.
"I think there was a part of me that thought I could run away from all that crazy horrible stuff," she said. "I was trying to find ways to be okay."
But the peace was fragile. When her father died in 1991, Hope became so depressed, she fell into a stupor. She was hospitalized, and for the first time, a psychiatrist listened as she talked about her childhood abuse. It was eye-opening, but therapy offered limited relief. She grew well enough to leave the hospital but found little joy outside.
In 1998, she suffered another breakdown after learning from a friend that the man who'd sexually abused her was under investigation for molesting another girl.
Under the weight of stress and emotion, Hope's carefully constructed shell began to crack.
"I started having these outrageous flashbacks, and body memories," she recalled. "The first time, I thought someone slipped me a drug. Because it would be these unstoppable, full-body blackout memories, and people would tell me later, 'You were just screaming for an hour.' "
She stopped sleeping. Her stomach problems worsened; she vomited every time she ate.
Once again, she checked herself into the hospital. Once again, it was all the doctors could do just to tape the pieces back together.
"I became like a survival machine. And I'm kind of blessed, because I didn't become violent or hostile or self-destructive," she said.
At the same time, a "normal" life felt out of reach. "It was kind of like, 'OK, I got to survive. But for what?'"