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Precipitated by an unhealthy weight, bad eating habits, and drug use, Garcia collapsed into a diabetic coma in 1986, waking up five days later. Garcia later spoke about this period of unconsciousness as surreal: "Well, I had some very weird experiences. My main experience was one of furious activity and tremendous struggle in a sort of futuristic, space-ship vehicle with insectoid presences. After I came out of my coma, I had this image of myself as these little hunks of protoplasm that were stuck together kind of like stamps with perforations between them that you could snap off." Garcia's coma had a profound effect on him: it forced him to have to relearn how to play the guitar, as well as other, more basic skills. Within a handful of months, Garcia quickly recovered, playing with the Jerry Garcia Band and the Grateful Dead again later that year. Garcia frequently saw a woman named Manasha Matheson during this period. Together they produced Garcia's fourth and final child, a girl named Keelin Noel Garcia, who was born December 20, 1987. Jerry, Keelin and Manasha toured and shared a home together as a family until 1993. During the creation of Built to Last in 1989, Garcia relapsed. In 1991, Garcia was confronted by the Grateful Dead with another intervention. After a disastrous meeting, Garcia invited Phil Lesh over to his home in San Rafael, California, where he explained that after the meeting he would start attending a methadone clinic. Garcia cited that he simply wanted to clean up in his own way.

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