A compassionate accounting of a complex and seemingly unsolvable problem, this book takes a fictionalized look at a real-life physician’s perspective of drug addiction, focusing on fentanyl, heroin and opiates, and the depths of despair such an addiction cannot help but reveal.

As Dr Chen, who runs a Toronto-based addiction clinic and research center, our fictional third person POV narrator, tries to do his very best for his patients, he inevitably faces moral dilemmas and must rely on the judiciousness of his experience, as he encounters desperate and manipulative patients, suffering and out-of-control, in situations as bleak as they are heartrending.

Addictions for which, although somewhat alleviated by the tools modern medicine can provide, may be seen as merely transferred through treatment from one drug to another perhaps more manageable alternative.

As Dr Chen becomes ever more intertwined in the particularly heartbreaking world of Claire, a heroin-addicted violinist with talent and a seemingly broad world of opportunity, and Bella, a romantically-charged pharmaceutical rep with a vested interest in involving him in a new addiction-treatment modality, Dr Chen may or may not be in danger of losing some of his professional objectivity.

Hard to read in its unflinching and doubtlessly realistic portrayal of suffering, this is a book that will open your eyes to the depths experienced by those in the grips of this terrible problem, and the incredible strength and sensitivity of those who care for them.

A great big thank you to Netgalley, the author, and the publisher for an ARC of this book. All thoughts presented are my own.

I am a fan of Bloodletting and Miraculous Cures, and I enjoyed this window on Chen's life later in his career. That said, this is a standalone novel, and readers don't need to be familiar with the previous book.

I was hesitant to start this book because of the subject matter: I knew it would not be a light read. But I'm very glad I did read it. It gave me a much better appreciation for the human side of the opioid crisis I've read about in the news, and it was also just a great (Canadian!) story. I'll be recommending it widely.

Thanks to the publisher and to NetGalley for the opportunity to read an electronic version of the ARC.