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On the Ravine
Dr. Chen, a downtown Toronto addictions doctor, is on the devastating front line of the opioid crisis. Grappling with ever-more desperate cases that arrive in his waiting room, he walks a tightrope between the human desires of his patients and the scientific doctrines of his profession. Chen is haunted by a photo gallery of patients he has lost to overdose. He asks: What if he had done more, or less? Or something different? Would his patients still be alive?
Claire, a passionate and highly accomplished violinist, suffers two overdoses in twenty-four hours, leading her to Chen's clinic. She is convinced that her most beautiful music is played when she is high on opioids, but has realized that her survival depends upon being sober. Their worlds collide, drawing Chen deeper into the intricate web of the doctor-patient relationship: the implications and consequences of his intention to treat. Chen must decide just how far he would go to save a life. Can he find choices that make a difference, and can he help his patients to do the same?
Combining the depth of his experience as a physician with the brilliance of his literary talent, Vincent Lam creates a world electric in its precision, radiant in its detail. On the Ravine is a gripping novel of profound emotional force, a soaring achievement from a singular voice in Canadian fiction.
Claire, a passionate and highly accomplished violinist, suffers two overdoses in twenty-four hours, leading her to Chen's clinic. She is convinced that her most beautiful music is played when she is high on opioids, but has realized that her survival depends upon being sober. Their worlds collide, drawing Chen deeper into the intricate web of the doctor-patient relationship: the implications and consequences of his intention to treat. Chen must decide just how far he would go to save a life. Can he find choices that make a difference, and can he help his patients to do the same?
Combining the depth of his experience as a physician with the brilliance of his literary talent, Vincent Lam creates a world electric in its precision, radiant in its detail. On the Ravine is a gripping novel of profound emotional force, a soaring achievement from a singular voice in Canadian fiction.
384 pages, Paperback
First published February 28, 2023
83 people are currently reading
2625 people want to read
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September 11, 2023
This story takes place in Toronto Canada where Dr. Chen runs a clinic called The Swan. His patients are drug addicts and Dr. Chen prescribes methadone or buprenorphine to handle withdrawal symptoms. He is also a consulting doctor for prescription drug trials. Claire is a violinist who got addicted to opiates after suffering a shoulder injury and eventually graduated to injecting heroin and fentanyl. In the hopes of getting a handle on her addiction she attends Dr. Chen's clinic. There's also another storyline running which involves Dr. Chen's colleague Dr. Fitzgerald who has his own addiction to alcohol and can no longer practise medicine. He seems to be running a safe injection site out of his large crumbling home on the ravine. I guess it's necessary to read Dr. Lam's previous book to get the entire background on these characters.
I found myself much more immersed in this novel than I expected; as a matter of fact it had me more enthralled than almost anything else I've read recently. As I was reading the first 25 pages or so I wondered what I had gotten myself into; the content was a bit dry. But then we got into Claire's story and I was totally engrossed and had trouble putting it down. The events are related by Dr. Chen and Claire separately, interspersed with letters written by Dr. Chen "to a student of medicine" who is never really identified but through these lettters we eventually learn her connection to the doctor. This book is definitely timely what with the opioid crisis pretty much everywhere. I don't have first-hand, or even second-hand, experience with drug users but the characters and stories seem very authentic and I'd assume Dr. Lam is drawing on his professional experience. Incredibly well written and heartbreaking. The ending leaves you hanging but I think it's appropriate in this case; kind of hope for the best but suspect the worst.
Trigger Warning: This story deals with intravenous drug use with graphic descriptions of the process and the consequences. It might be difficult to read if you're squeamish or in recovery.
This was an ARC and there wasn't a lot of formatting, not even chapter breaks, so I did get slightly confused at times. Hopefully the published version will be a bit easier to follow.
My wholehearted thanks to Penguin Random House Canada via Netgalley for the opportunity to read an advance copy of this excellent novel. All opinions expressed are my own.
Publication Date: February 28, 2023
I found myself much more immersed in this novel than I expected; as a matter of fact it had me more enthralled than almost anything else I've read recently. As I was reading the first 25 pages or so I wondered what I had gotten myself into; the content was a bit dry. But then we got into Claire's story and I was totally engrossed and had trouble putting it down. The events are related by Dr. Chen and Claire separately, interspersed with letters written by Dr. Chen "to a student of medicine" who is never really identified but through these lettters we eventually learn her connection to the doctor. This book is definitely timely what with the opioid crisis pretty much everywhere. I don't have first-hand, or even second-hand, experience with drug users but the characters and stories seem very authentic and I'd assume Dr. Lam is drawing on his professional experience. Incredibly well written and heartbreaking. The ending leaves you hanging but I think it's appropriate in this case; kind of hope for the best but suspect the worst.
Trigger Warning: This story deals with intravenous drug use with graphic descriptions of the process and the consequences. It might be difficult to read if you're squeamish or in recovery.
This was an ARC and there wasn't a lot of formatting, not even chapter breaks, so I did get slightly confused at times. Hopefully the published version will be a bit easier to follow.
My wholehearted thanks to Penguin Random House Canada via Netgalley for the opportunity to read an advance copy of this excellent novel. All opinions expressed are my own.
Publication Date: February 28, 2023
September 1, 2023
I thought that this book did a nice job of portraying the complexities of addiction as well as what it feels like to work as a health care provider trying to care for those with substance use disorders. Vincent Lam highlights the harrowing journey of someone struggling with an opioid use disorder in a way that shows the hardship caused by the disorder without stigmatizing it. I liked that Lam showed the ups and downs of the treatment process and how difficult and hopeless it can feel, even when you’re not willing to give up on either yourself or your patient.
I felt that Lam’s writing was a bit stiff and repetitive which detracted from my enjoyment of the novel. Still, I can see how much Lam cares about his patients and these issues, and I commend him for such a compassionate and real take on working with those with substance use disorders.
I felt that Lam’s writing was a bit stiff and repetitive which detracted from my enjoyment of the novel. Still, I can see how much Lam cares about his patients and these issues, and I commend him for such a compassionate and real take on working with those with substance use disorders.
March 1, 2023
🎶 Happy Publication Day 🎶
Thank you to NetGalley, Penguin Random House and Knopf Canada for the arc in exchange for an honest review.
I’m a big fan of Vincent Lam’s work. I still think about the ending of The Headmaster’s Wager, years after reading it. In this book, we revisit two of the characters from Lam’s Giller Prize winning piece, Bloodletting and Miraculous Cures. However, there’s no absolute need to re-read Bloodletting in order to appreciate this book.
Dr. Chen and his friend/ colleague Fitzgerald are battling the opioid crisis in Toronto in two distinctly different ways.
It’s interesting to see how Dr. Chen, a licensed medical doctor - a professional - takes such a personal interest in his patients of addictions medicine. He keeps photos, in his phone, of patients who have died from drug-related causes, waking in the middle of the night to scroll through them again and again, wondering what he could have done differently, trying to fit the puzzle pieces together.
Fitzgerald, on the other hand, now stripped of his license, is a bit detached from the scene, objectively doling out clean drugs to users, to keep them from dying from the unknowns out there.
Both men had started an addictions clinic, now run by Dr. Chen, and a clinical trial company that runs trials for pharmaceutical drugs that have the potential to offer some kind of reprieve to the addicted.
The character that links Chen, Fitzgerald, the clinic and the clinical trial company is Claire, a talented violinist who is first exposed to opioids in Germany where she falls down some stairs, injuring her shoulder, while she is there for a key performance for a scholarship. The drugs are miraculous. They allow her to continue her passion, her life’s work. It’s the innocent first step of the downward spiral.
We follow Claire, through Chen’s eyes as her doctor, as addiction changes her life and the lives of those around her.
What the novel did for me was to show me a clear progression of how addiction takes hold and drags one under. We hear it all the time: soccer moms, college students, executives… the least likely candidates for addiction are becoming addicted and losing everything. How and why does it happen? Is it that easy? We think we’re all able to withstand addiction. “That would never be me!” “Only weak people become addicts.” The reality is, maybe we’re one dislocated shoulder away from a very steep and slippery slope.
In Chen and Fitzgerald I saw two sides of one doctor. The side that wants to personally take care of his patients, to be involved and responsible. Also the side that does what needs to be done - prevent them from dying and that’s enough. Can both sides co-exist in one doctor? It’s a stretch and, I imagine, a struggle.
I loved this novel, not for its difficult subject matter, but because it showed me how truly complicated addiction is, how quickly it can happen and how incredibly difficult it would be to extract oneself from this disease. It was enlightening, as Dr. Lam works in addictions medicine and writes from deep knowledge and experience.
Aside from the story, the prose is gorgeous. Lam paints a vivid picture of the city, the people and their struggles, with words and imagery almost set to music. Just a beautiful read.
Highly recommended.
Thank you to NetGalley, Penguin Random House and Knopf Canada for the arc in exchange for an honest review.
I’m a big fan of Vincent Lam’s work. I still think about the ending of The Headmaster’s Wager, years after reading it. In this book, we revisit two of the characters from Lam’s Giller Prize winning piece, Bloodletting and Miraculous Cures. However, there’s no absolute need to re-read Bloodletting in order to appreciate this book.
Dr. Chen and his friend/ colleague Fitzgerald are battling the opioid crisis in Toronto in two distinctly different ways.
It’s interesting to see how Dr. Chen, a licensed medical doctor - a professional - takes such a personal interest in his patients of addictions medicine. He keeps photos, in his phone, of patients who have died from drug-related causes, waking in the middle of the night to scroll through them again and again, wondering what he could have done differently, trying to fit the puzzle pieces together.
Fitzgerald, on the other hand, now stripped of his license, is a bit detached from the scene, objectively doling out clean drugs to users, to keep them from dying from the unknowns out there.
Both men had started an addictions clinic, now run by Dr. Chen, and a clinical trial company that runs trials for pharmaceutical drugs that have the potential to offer some kind of reprieve to the addicted.
The character that links Chen, Fitzgerald, the clinic and the clinical trial company is Claire, a talented violinist who is first exposed to opioids in Germany where she falls down some stairs, injuring her shoulder, while she is there for a key performance for a scholarship. The drugs are miraculous. They allow her to continue her passion, her life’s work. It’s the innocent first step of the downward spiral.
We follow Claire, through Chen’s eyes as her doctor, as addiction changes her life and the lives of those around her.
What the novel did for me was to show me a clear progression of how addiction takes hold and drags one under. We hear it all the time: soccer moms, college students, executives… the least likely candidates for addiction are becoming addicted and losing everything. How and why does it happen? Is it that easy? We think we’re all able to withstand addiction. “That would never be me!” “Only weak people become addicts.” The reality is, maybe we’re one dislocated shoulder away from a very steep and slippery slope.
In Chen and Fitzgerald I saw two sides of one doctor. The side that wants to personally take care of his patients, to be involved and responsible. Also the side that does what needs to be done - prevent them from dying and that’s enough. Can both sides co-exist in one doctor? It’s a stretch and, I imagine, a struggle.
I loved this novel, not for its difficult subject matter, but because it showed me how truly complicated addiction is, how quickly it can happen and how incredibly difficult it would be to extract oneself from this disease. It was enlightening, as Dr. Lam works in addictions medicine and writes from deep knowledge and experience.
Aside from the story, the prose is gorgeous. Lam paints a vivid picture of the city, the people and their struggles, with words and imagery almost set to music. Just a beautiful read.
Highly recommended.
February 8, 2023
I was so excited to read On the Ravine by Dr. Vincent Lam after loving Bloodletting and Miraculous Cures many years ago.
I just finished it last night and am still in the process of formulating my thoughts so they may change a bit. My early thoughts are that this was a very good book about a very difficult topic.
In this story, which features two characters from his previous book (but it is not necessary to have read the other one to enjoy this one), we are given a very deep look at drug addiction. Dr. Chen runs a clinic called The Swan where he sees patients each day who are dealing with drug addiction. In addition to putting patients on methadone or Buprenorphine to settle their withdrawal symptoms, he is also a consulting doctor for drug trials. In comes Claire, an aspiring professional violinist. Claire has been using Oxycodone and heroin as an IV drug user and needs assistance in coming off the drugs. This is the beginning of a precarious doctor/patient relationship.
Addiction is a beast that many cannot reckon with. The chemical dependency and increasing tolerance usually results in the person using more drugs, more dangerously and experiencing withdrawal more and more quickly. Harm reduction is the current method used to stabilize patients but doesn’t offer freedom. The role of the doctor in determining just how much of an opioid will have the patient become a functioning person is a difficult balance and it is tested by addicts who will manipulate and lie to obtain their high. Please don’t take this as me judging addicts, this is not so simply the result of a chemical that has taken over the addict’s life.
In the story, Claire fights this battle and tells Dr. Chen that what she wants most is to be able to play her violin and become the music. She wants to reach beyond the formulaic playing of her violin and become immersed in the music. In addition to desperately wanting relief from her addiction, she has a sister who comes to stay with her who is also an addict. As someone who has worked as a youth worker with street addicted youth, we often say “people, places, and things” need to change in order for success.
When Dr. Chen contacts Claire after she has had two overdoses and tells her that he believes she may be suitable for a new drug trial, Claire jumps in with both feet.
Lam has written a story that one must finish to appreciate. The beginning third of the book takes its time in setting up what a drug trial looks like, the decline in an addict-especially with fentanyl out there, and the push and pull of a doctor who works in the field. I am concerned some will find this part of the book a little dry and not continue but I urge you to trust the process.
Dr. Chen is an interesting character on his own with his big heart and wanting to do the best for his patients. He is a hero character with faults and hindsight.
Big pharma and the interests of the players in the field was a little less dramatic and at times a bit lengthy but played a role in the crux of the story.
Thinking about the audience for this book has been with me during the night. This book could be highly triggering for anyone in recovery, or an active user. The processes and terms are very detailed and even the descriptions of dealers, users, drugs, places, and equipment has the potential to activate an addict’s brain to want to use. For those that are interested in the field of addiction or who can manage difficult stories, then I would feel comfortable in recommending this book.
With more and more deadly drugs on the street, this could also be a call to action. I live in Vancouver, Canada and we are currently experiencing overdoses at alarming rates. One of the pushes is to legalize drugs and offer a safe supply. Recent legislation passed has allowed small amounts of drugs to be carried without penalty but that doesn’t stop those drugs from being laced with fentanyl or carfentanil. Safe injection sites are available and drug testing kits and more people are being trained on how to use Nalaxone kits. I would be interested in revisiting this book in ten years and seeing how it fits into reality then.
Thank you to @netgalley and @penguinrandomca for an ARC of On the Ravine. It publishes February 28, 2023.
I just finished it last night and am still in the process of formulating my thoughts so they may change a bit. My early thoughts are that this was a very good book about a very difficult topic.
In this story, which features two characters from his previous book (but it is not necessary to have read the other one to enjoy this one), we are given a very deep look at drug addiction. Dr. Chen runs a clinic called The Swan where he sees patients each day who are dealing with drug addiction. In addition to putting patients on methadone or Buprenorphine to settle their withdrawal symptoms, he is also a consulting doctor for drug trials. In comes Claire, an aspiring professional violinist. Claire has been using Oxycodone and heroin as an IV drug user and needs assistance in coming off the drugs. This is the beginning of a precarious doctor/patient relationship.
Addiction is a beast that many cannot reckon with. The chemical dependency and increasing tolerance usually results in the person using more drugs, more dangerously and experiencing withdrawal more and more quickly. Harm reduction is the current method used to stabilize patients but doesn’t offer freedom. The role of the doctor in determining just how much of an opioid will have the patient become a functioning person is a difficult balance and it is tested by addicts who will manipulate and lie to obtain their high. Please don’t take this as me judging addicts, this is not so simply the result of a chemical that has taken over the addict’s life.
In the story, Claire fights this battle and tells Dr. Chen that what she wants most is to be able to play her violin and become the music. She wants to reach beyond the formulaic playing of her violin and become immersed in the music. In addition to desperately wanting relief from her addiction, she has a sister who comes to stay with her who is also an addict. As someone who has worked as a youth worker with street addicted youth, we often say “people, places, and things” need to change in order for success.
When Dr. Chen contacts Claire after she has had two overdoses and tells her that he believes she may be suitable for a new drug trial, Claire jumps in with both feet.
Lam has written a story that one must finish to appreciate. The beginning third of the book takes its time in setting up what a drug trial looks like, the decline in an addict-especially with fentanyl out there, and the push and pull of a doctor who works in the field. I am concerned some will find this part of the book a little dry and not continue but I urge you to trust the process.
Dr. Chen is an interesting character on his own with his big heart and wanting to do the best for his patients. He is a hero character with faults and hindsight.
Big pharma and the interests of the players in the field was a little less dramatic and at times a bit lengthy but played a role in the crux of the story.
Thinking about the audience for this book has been with me during the night. This book could be highly triggering for anyone in recovery, or an active user. The processes and terms are very detailed and even the descriptions of dealers, users, drugs, places, and equipment has the potential to activate an addict’s brain to want to use. For those that are interested in the field of addiction or who can manage difficult stories, then I would feel comfortable in recommending this book.
With more and more deadly drugs on the street, this could also be a call to action. I live in Vancouver, Canada and we are currently experiencing overdoses at alarming rates. One of the pushes is to legalize drugs and offer a safe supply. Recent legislation passed has allowed small amounts of drugs to be carried without penalty but that doesn’t stop those drugs from being laced with fentanyl or carfentanil. Safe injection sites are available and drug testing kits and more people are being trained on how to use Nalaxone kits. I would be interested in revisiting this book in ten years and seeing how it fits into reality then.
Thank you to @netgalley and @penguinrandomca for an ARC of On the Ravine. It publishes February 28, 2023.
November 28, 2025
Follows addiction medicine physician Chen and his patient, violinist Claire, as it explores the ambiguities and challenges of addiction and its treatment. Chen prescribes buprenorphine and methadone with a view to stabilizing his patients and removing the pressure of withdrawal, but he can't rid them of the memory of past highs and whatever drove them to use in the first place. He browses photos on his phone of dead and missing patients, and crosses boundaries in his efforts to help his patient population. His former colleague Fitzgerald now operates outside the bounds of medicine and the law by providing a wider range of pharmaceutical-grade drugs to users in his fancy home-turned-shooting-gallery. And Chen moonlights as a clinical investigator for experimental drug trials, in which a new drug holds the potential of ridding people of the memories that propel them to substance use.
I thought Lam did a good job conveying how many ambiguities there are in this area, and some of the cyclical, spiralling nature of addiction. The narrative did not quite take off for me, however - it was trying to cram in a lot of plot, a lot of thoughts, a lot that as an addiction physician himself he is probably processing. I was also bothered by plot holes and Chen's increasing traversing of boundaries with his patients was quite disturbing, but I wasn't if the author perceived it as such. Certainly a thought-provoking read in any case.
I thought Lam did a good job conveying how many ambiguities there are in this area, and some of the cyclical, spiralling nature of addiction. The narrative did not quite take off for me, however - it was trying to cram in a lot of plot, a lot of thoughts, a lot that as an addiction physician himself he is probably processing. I was also bothered by plot holes and Chen's increasing traversing of boundaries with his patients was quite disturbing, but I wasn't if the author perceived it as such. Certainly a thought-provoking read in any case.
February 8, 2023
I received an ARC of On the Ravine from NetGalley in return for a fair review.
Vincent Lam's collection of stories about a group of medical students in Toronto, Bloodletting & Miraculous Cures was a Giller Prize winning and hugely popular book published in 2005. I came to know it very well as I taught it in a grade 11 University English course a couple of years after its publication.
On the Ravine picks up the story of two of the med students, Fitz and Chen, who have developed a practice in addictions, a clinic to help those trying to get off heroin and opioids and a highly respected cooperation with pharmaceutical companies to develop new alternatives to the standard methadone and buprenorphine. Chen works tirelessly to help all his patients, sometimes finding himself in situations that challenge his values and medical ethics. His relationship with a very talented violinist addicted to opioids, first prescribed because of a shoulder injury, is a powerful thread throughout the story. Fitz's less orthodox attitude to addicts is a foil to Chen's mostly 'by the book' methods and their continued friendship allows the reader to see how fine the lines are within an often hopeless quest to help and protect those with addiction illness.
Lam's own professional involvement in the addiction community of Toronto is the authentic voice but the stories are all out in there in the media - the explosion of 'bad' adulterated heroin and cocaine and the rising death toll in opioid addiction. Notwithstanding Chen's dark world, he is a believable light who is not deterred by the low success rate. Lam does not create a medical saint in Chen but a caring, likeable physician whose life is governed by his Hippocratic oath to do "Do No Harm", a strong sense of ethics and a desire to do better.
Vincent Lam's collection of stories about a group of medical students in Toronto, Bloodletting & Miraculous Cures was a Giller Prize winning and hugely popular book published in 2005. I came to know it very well as I taught it in a grade 11 University English course a couple of years after its publication.
On the Ravine picks up the story of two of the med students, Fitz and Chen, who have developed a practice in addictions, a clinic to help those trying to get off heroin and opioids and a highly respected cooperation with pharmaceutical companies to develop new alternatives to the standard methadone and buprenorphine. Chen works tirelessly to help all his patients, sometimes finding himself in situations that challenge his values and medical ethics. His relationship with a very talented violinist addicted to opioids, first prescribed because of a shoulder injury, is a powerful thread throughout the story. Fitz's less orthodox attitude to addicts is a foil to Chen's mostly 'by the book' methods and their continued friendship allows the reader to see how fine the lines are within an often hopeless quest to help and protect those with addiction illness.
Lam's own professional involvement in the addiction community of Toronto is the authentic voice but the stories are all out in there in the media - the explosion of 'bad' adulterated heroin and cocaine and the rising death toll in opioid addiction. Notwithstanding Chen's dark world, he is a believable light who is not deterred by the low success rate. Lam does not create a medical saint in Chen but a caring, likeable physician whose life is governed by his Hippocratic oath to do "Do No Harm", a strong sense of ethics and a desire to do better.
May 25, 2023
This is not an easy book. But it is an important book. A revelation of lives and experience I hope never to have, and wouldn't wish on anyone.
It's also an exploration of the decisions we make and the paths we choose.
It's also an exploration of the decisions we make and the paths we choose.
didn-t-finish
May 6, 2023Couldn’t stand the narrator, he seemed to read all sentences the same. It became quite annoying and I was disappointed that I had to stop. I really enjoyed Bloodletting and Other Miraculous Cures.
June 10, 2023
WHY WHY WHY?????..Do authors insist on narrating their own work? Lam’s narration was soooo slow ( even sped up 30%) it was stilted and painful to listen to. I barely got through 5 minutes before abandoning. Very sad as I thought his Bloodletting book was brilliant. Having persevered through Adam Verghese’s too slow narration but wonderful Covenant of Water recently, I had no patience for this once I heard Lam’s unprofessional narration. If authors are going to spend so much of their life on writing a book, they must understand they need to hire a good publisher and a good narrator to present it.
March 14, 2023
This new novel from Canadian author Vincent Lam hit super close to home as a former harm reduction worker in a safe injection site. I have seen the ways in which opiates tear peoples lives apart and the ways in which the powers in society truly could care less.
It can be a hopeless feeling but telling these stories is so important and Lam did it with grace.
Thank you to the publisher and netgalley for the arc.
It can be a hopeless feeling but telling these stories is so important and Lam did it with grace.
Thank you to the publisher and netgalley for the arc.
February 15, 2023
[arc review]
Thank you to NetGalley, Penguin Random House Canada, and Knopf Canada for providing an arc in exchange for an honest review.
On the Ravine releases February 28, 2023
“Even if we make the withdrawal go away, we can’t take away the memory of the high.”
This title features two characters from Vincent Lam’s Bloodletting & Miraculous Cures — Chen and Fitzgerald. These are both standalone novels, and while it’s not necessary to read Bloodletting & Miraculous Cures in order to understand On the Ravine, it would provide more character background.
CW: opioid addiction, racial slurs
This entire novel is heavily centered around opioids, addiction, addiction clinics, and drug trials. There are many descriptive in-depth scenes about drug use, including needle injections, pill use, highs, withdrawal symptoms, and overdoses. Please keep this in mind to gauge whether or not you’re in the proper headspace to handle content surrounding these topics.
The two main characters here are Claire and Chen, with some sparse input from Fitzgerald (but he mainly takes a backseat here).
Claire is a violinist who has a serious opioid addiction that originally stemmed from an injury.
Chen often frequents the restaurant that Claire plays at, and eventually progresses to being her doctor. He tries so adamantly to help her with her addiction but there is an endless cycle for seeking a high.
There are also letters scattered throughout between Chen and a former student of his, although the student is never named.
I’m no stranger to the adverse struggles of addiction, and I’ve seen it first hand for years in the DTES (Vancouver). I think Lam definitely used his experience and knowledge in the medical field to his advantage. However, with that being said, I did find it difficult to focus solely on this book, and often times found myself reaching for my phone or literally anything else. The narrative was a bit lengthy in the beginning and maybe could have cut down on some repetition.
I’m also so confused, because having read Bloodletting & Miraculous Cures, I was expecting to see a mention of Ming (who Chen apparently married), but there was zero instances of this. Instead, he was comingling with some woman named Bella?! It’s like I went from A to C, and B got lost in a blackhole.
Thank you to NetGalley, Penguin Random House Canada, and Knopf Canada for providing an arc in exchange for an honest review.
On the Ravine releases February 28, 2023
“Even if we make the withdrawal go away, we can’t take away the memory of the high.”
This title features two characters from Vincent Lam’s Bloodletting & Miraculous Cures — Chen and Fitzgerald. These are both standalone novels, and while it’s not necessary to read Bloodletting & Miraculous Cures in order to understand On the Ravine, it would provide more character background.
CW: opioid addiction, racial slurs
This entire novel is heavily centered around opioids, addiction, addiction clinics, and drug trials. There are many descriptive in-depth scenes about drug use, including needle injections, pill use, highs, withdrawal symptoms, and overdoses. Please keep this in mind to gauge whether or not you’re in the proper headspace to handle content surrounding these topics.
The two main characters here are Claire and Chen, with some sparse input from Fitzgerald (but he mainly takes a backseat here).
Claire is a violinist who has a serious opioid addiction that originally stemmed from an injury.
Chen often frequents the restaurant that Claire plays at, and eventually progresses to being her doctor. He tries so adamantly to help her with her addiction but there is an endless cycle for seeking a high.
There are also letters scattered throughout between Chen and a former student of his, although the student is never named.
I’m no stranger to the adverse struggles of addiction, and I’ve seen it first hand for years in the DTES (Vancouver). I think Lam definitely used his experience and knowledge in the medical field to his advantage. However, with that being said, I did find it difficult to focus solely on this book, and often times found myself reaching for my phone or literally anything else. The narrative was a bit lengthy in the beginning and maybe could have cut down on some repetition.
I’m also so confused, because having read Bloodletting & Miraculous Cures, I was expecting to see a mention of Ming (who Chen apparently married), but there was zero instances of this. Instead, he was comingling with some woman named Bella?! It’s like I went from A to C, and B got lost in a blackhole.
March 24, 2023
Dr Chen runs a clinic for drug addicts. He’s used to people arriving at different stages of their addictions and for different reasons, and for some of them to suddenly disappear, while others learns to manage their conditions. He’s noticed the rapidly rising numbers of people addicted to fentanyl and other opiates. He also takes solace in the evenings from his difficult job by listening to a violinist at a nearby restaurant.
Claire is this violinist; she injured her shoulder some time ago, and during her painful and frustrating recovery, became addicted to opiates, and has graduated to injecting fentanyl and heroin. She decides to visit Dr. Chen's clinic when her life begins spiralling out of control.
Claire desperately wants an end to her addiction, and everything that goes with it: the highs, the lows, the physiological and mental effects of her addiction, and her increasingly precarious employment and financial situations.
When a representative of a pharmaceutical company comes to Chen with a possible drug which can terminate the cycle of addiction, Chen convinces Claire to participate, leading to unforeseen and tragic circumstances.
This is a quiet novel; Vincent Lam's prose is simple, but also wonderful at creating atmosphere. The content is tough at times to get through, mainly because the real life situation of a huge number of people addicted to opiates, and so lives ruined.
It's clear Vincent Lam's professional experience working with drug addicts informed this novel, which so well describes the complicated situation facing society when so many are suffering from opiod addictions. There are no easy solutions, and while I felt some despair while reading, I liked the somewhat ambivalent ending of this well crafted, deeply sympathetic novel.
Thank you to Netgalley and to Penguin Random House Canada for this ARC in exchange for my review.
Claire is this violinist; she injured her shoulder some time ago, and during her painful and frustrating recovery, became addicted to opiates, and has graduated to injecting fentanyl and heroin. She decides to visit Dr. Chen's clinic when her life begins spiralling out of control.
Claire desperately wants an end to her addiction, and everything that goes with it: the highs, the lows, the physiological and mental effects of her addiction, and her increasingly precarious employment and financial situations.
When a representative of a pharmaceutical company comes to Chen with a possible drug which can terminate the cycle of addiction, Chen convinces Claire to participate, leading to unforeseen and tragic circumstances.
This is a quiet novel; Vincent Lam's prose is simple, but also wonderful at creating atmosphere. The content is tough at times to get through, mainly because the real life situation of a huge number of people addicted to opiates, and so lives ruined.
It's clear Vincent Lam's professional experience working with drug addicts informed this novel, which so well describes the complicated situation facing society when so many are suffering from opiod addictions. There are no easy solutions, and while I felt some despair while reading, I liked the somewhat ambivalent ending of this well crafted, deeply sympathetic novel.
Thank you to Netgalley and to Penguin Random House Canada for this ARC in exchange for my review.
March 14, 2023
I needed to take a bit of time after finishing On the Ravine before writing my review. Although this book is fiction, the topic of addiction is a difficult one and to read about the Claire as she tries overcome her opioid addiction was hard.
Although this is a follow up book to Vincent Lam's first, it is not necessary to read before On the Ravine as Lam does a great job of developing the two main characters, one who is in the first book, Dr. Chen a doctor at a clinic that does drugs trials and Claire who we meet is one of his patients trying to get clean. The descriptions of drug use and how addiction works were at times hard to read as you just want to tell them to stop using, which I know doesn't work.
I know I'm going to be in the minority, but I wasn't a huge fan of the book. It took awhile to get into and I did enjoy some of it, even it Dr. Chen's involvement in Claire's life is a bit far fetched. The ending also seems to wrap up pretty fast, for a book with such a drawn out beginning.
Thank you to NetGalley, Penguin Random House Canada and Knopf Canada for the advanced copy in exchange for my honest review.
Although this is a follow up book to Vincent Lam's first, it is not necessary to read before On the Ravine as Lam does a great job of developing the two main characters, one who is in the first book, Dr. Chen a doctor at a clinic that does drugs trials and Claire who we meet is one of his patients trying to get clean. The descriptions of drug use and how addiction works were at times hard to read as you just want to tell them to stop using, which I know doesn't work.
I know I'm going to be in the minority, but I wasn't a huge fan of the book. It took awhile to get into and I did enjoy some of it, even it Dr. Chen's involvement in Claire's life is a bit far fetched. The ending also seems to wrap up pretty fast, for a book with such a drawn out beginning.
Thank you to NetGalley, Penguin Random House Canada and Knopf Canada for the advanced copy in exchange for my honest review.
July 17, 2023
It's been years since I read Bloodletting and Miraculous Cures and I still remember Vincent Lam's skill and artistry in building a narrative. This is sort of a sequel, picking up with the characters Chen and Fitzgerald years later, and it doesn't disappoint.
On the Ravine is a front line view of the opioid crisis, through the eyes of an addictions clinic, a drug trial, and a musically talented junkie. Despite an early hopeful tone, the book becomes richer and more complicated as the story goes on. This book does a masterful job of portraying flawed characters and blurred ethical lines without being a slog of heavy reading. Five stars.
On the Ravine is a front line view of the opioid crisis, through the eyes of an addictions clinic, a drug trial, and a musically talented junkie. Despite an early hopeful tone, the book becomes richer and more complicated as the story goes on. This book does a masterful job of portraying flawed characters and blurred ethical lines without being a slog of heavy reading. Five stars.
October 16, 2023
IMHO an accurate depiction of opioid addiction and our approach to treatment. I think the plot got a little too convoluted 3/4 of the way through and it detracted from the main story and message, but still a really good listen.
This entire review has been hidden because of spoilers.
August 14, 2024
great read; the stories in here resembled so much of what ive come across so far working in addictions med
February 15, 2025
This book did a great job at painting the complexities of addiction and the system, while also reminding us that these are real people with unique stories.
May 18, 2023
5/5 stars! (Adult read) A heartbreaking read about drugs/addictions and the effects they have on people’s lives. The story follows two doctors with very different approaches to the opioid crisis. This book had me emotionally tied to the characters and wanting happy endings for all - but that’s not the reality of addiction. This is apparently a sequel but reads as a stand-alone. I really enjoyed it.
February 7, 2023
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.
November 18, 2025
This is about the realities of addiction and I’d recommend reading it anytime except the winter tbh, a lot of despair to contend with
July 25, 2023
This FINALLY got me out of a months-long reading slump (also reading post partum is challenging and maybe I should invest in a kindle when nap trapped) and it was so interesting. I don’t work in harm reduction, but do work harm-reduction adjacent and the empathy required to work with people who struggle with addictions is spot on. You want to help so bad. I love the way Vincent Lam writes. I might have to reread Bloodletting now.
March 22, 2023
I have long been hoping for a Vincent Lam follow-up to his first novel and was excited to be reunited with Chen and Fitzgerald in this timely and eloquent novel. Lam's work is is suitably contemporary and makes the reader face difficult situations that are of the real world, not the imaginary one. I applaud him for that, because often in our daily lives, we avoid seeing these difficulties unless it is a necessity to our circumstances. Through the eyes of Dr. Chen, we are able to see the complex problems of the medical world, and in this case, the world of drug addiction and pharmaceuticals. Lam's prose is both precise and lyrical, depending on his focus. Toronto is depicted realistically, with the beautiful and the ugly side by side.
I highly recommend On the Ravine, both for its wonderful prose and well drawn characters and for its thought -provoking take on the issue of illnesses and treatments.
I highly recommend On the Ravine, both for its wonderful prose and well drawn characters and for its thought -provoking take on the issue of illnesses and treatments.
March 15, 2023
The technical execution of this book is exactly what you'd expect from a Giller Prize-winning author; it builds in anxiety and tension throughout and all along the way, you're thinking to yourself 'how can this end?' and 'why do I feel so nauseous?'
This book spares no details on addiction and the opioid crisis in Canada. Prepare to really root for Claire and have your heart broken repeatedly.
Torontonians will recognize Chen's bike routes and encampments, and will hopefully be reminded that we are still in the midst of a crisis across this country. On the Ravine does a brilliant job of telling a story rooted in a harsh reality, and hopefully readers take it to heart (even if it's hard to make it past the first few chapters due to the weight of it all.)
This book spares no details on addiction and the opioid crisis in Canada. Prepare to really root for Claire and have your heart broken repeatedly.
Torontonians will recognize Chen's bike routes and encampments, and will hopefully be reminded that we are still in the midst of a crisis across this country. On the Ravine does a brilliant job of telling a story rooted in a harsh reality, and hopefully readers take it to heart (even if it's hard to make it past the first few chapters due to the weight of it all.)
August 24, 2023
Opened up a world of which I was totally unaware.
April 18, 2024
3.47 / 5
”your patient holds the torch in a dark room, but does not know how to light it. you are an expert in sparks, in how to strike flint on steel, and you are blind. whether the torch is lit, and what the room looks like, you will only know from your patient’s words. but it is no easy thing to light a torch using flint on steel, in a room where neither can see. most times, you will be told that your spark has vanished into darkness, and you may be disappointed when your patient says—again —doctor, it’s just as dark as before. you must offer to try again.”
i think this was one of the best books i read. this showed the complexity of addiction and the ups and downs of navigating one without sugarcoating any of it. it was a raw, uncomfortably real, and uncompromisingly poignant portrayal.
dr. chen -
honestly, i loved reading about dr. chen and his dynamics with his approach to his profession, his patients, and also fitzgerald. at times, the way he would help claire in ways that went beyond the workings of a medical professional did make me wonder whether it was a good idea or not and if it made me uncomfortable. i still don’t know how to feel about it but it was interesting to read his approach with claire—sometimes letting her do what she wants and sometimes offering a dose of tough advice that is necessary.
claire -
she is hands-down the character who made the reading experience that i had. she is a violinist who had a shoulder injury that required a prescription of painkillers. that led to heroin and then fentanyl. it was absolutely heart-wrenching to read how intertwined was her love for music, the need to keep her music alive, and her addiction. her enabler being her own sister, molly, also posed as an obstacle that further made recovery tough.
the plot -
the plot had a number of subplots that weaved together to make a brilliant ending, in my opinion. ranging from the drug trials regarding the memorex drug that can cure addiction, fitzgerald’s approach to addiction, and the letters, it all came together in the end. and the ending, too, was neither a silver lining, a glimmer of hope, or something even close to bliss. it seemed like a price, neither an answer nor an outcome we hope for.
i would have loved to learn more about claire and molly’s childhood though. it felt like the book suffered a bit without showing a bit more of the backgrounds of the two when they, especially claire, are such an integral part of the plot.
apart from that, i might be irrationally miffed by how physician-centred it was to the point that other options for lack of a better word in the realm of addiction recovery were overlooked. in this huge city of toronto, you have so many people, organizations, and methods of support when it comes to addiction and addiction recovery. addiction counsellors, care coordinators, recovery coaches, social workers—so many people and so many ways of supports. acknowledging their work and organizations such as CAMH, JACS, oasis, and etc. would have made the narrative even stronger in my opinion.
but again, i am not a medical professional so i might not have made the most adept suggestion.
the writing -
the writing style was stiff to me, i don’t know why. maybe i am more of a person who prefers ornate and descriptive language which is why i couldn’t gel with the style but it irked me at times. but when i would read the letters, i would be taken aback by how easily i was able to smooth through the text.
”your patient holds the torch in a dark room, but does not know how to light it. you are an expert in sparks, in how to strike flint on steel, and you are blind. whether the torch is lit, and what the room looks like, you will only know from your patient’s words. but it is no easy thing to light a torch using flint on steel, in a room where neither can see. most times, you will be told that your spark has vanished into darkness, and you may be disappointed when your patient says—again —doctor, it’s just as dark as before. you must offer to try again.”
i think this was one of the best books i read. this showed the complexity of addiction and the ups and downs of navigating one without sugarcoating any of it. it was a raw, uncomfortably real, and uncompromisingly poignant portrayal.
dr. chen -
honestly, i loved reading about dr. chen and his dynamics with his approach to his profession, his patients, and also fitzgerald. at times, the way he would help claire in ways that went beyond the workings of a medical professional did make me wonder whether it was a good idea or not and if it made me uncomfortable. i still don’t know how to feel about it but it was interesting to read his approach with claire—sometimes letting her do what she wants and sometimes offering a dose of tough advice that is necessary.
claire -
she is hands-down the character who made the reading experience that i had. she is a violinist who had a shoulder injury that required a prescription of painkillers. that led to heroin and then fentanyl. it was absolutely heart-wrenching to read how intertwined was her love for music, the need to keep her music alive, and her addiction. her enabler being her own sister, molly, also posed as an obstacle that further made recovery tough.
the plot -
the plot had a number of subplots that weaved together to make a brilliant ending, in my opinion. ranging from the drug trials regarding the memorex drug that can cure addiction, fitzgerald’s approach to addiction, and the letters, it all came together in the end. and the ending, too, was neither a silver lining, a glimmer of hope, or something even close to bliss. it seemed like a price, neither an answer nor an outcome we hope for.
i would have loved to learn more about claire and molly’s childhood though. it felt like the book suffered a bit without showing a bit more of the backgrounds of the two when they, especially claire, are such an integral part of the plot.
apart from that, i might be irrationally miffed by how physician-centred it was to the point that other options for lack of a better word in the realm of addiction recovery were overlooked. in this huge city of toronto, you have so many people, organizations, and methods of support when it comes to addiction and addiction recovery. addiction counsellors, care coordinators, recovery coaches, social workers—so many people and so many ways of supports. acknowledging their work and organizations such as CAMH, JACS, oasis, and etc. would have made the narrative even stronger in my opinion.
but again, i am not a medical professional so i might not have made the most adept suggestion.
the writing -
the writing style was stiff to me, i don’t know why. maybe i am more of a person who prefers ornate and descriptive language which is why i couldn’t gel with the style but it irked me at times. but when i would read the letters, i would be taken aback by how easily i was able to smooth through the text.
September 27, 2025
Being a great fan of Vincent Lam who in my view is the leading new talent of Canadian literature in the 21st century, I have often referred to him as Canada's Anton Chekhov. I did however think that Lam was guilty of hubris when he placed an epigraph from Chekhov on the page before the start of his novel: "We shall find peace. We shall hear angels. We shall see the sky sparkling from diamonds." "On the Ravine" (2023) is a fine novel but I enjoyed it much less than either "The Headmaster's Wager" (2012) or "Bloodletting and Miraculous Cures" (2006).
"On the Ravine" is above all topical. It gives the reader the a look behind the headlines. Like his protagonist Dr. Chen, Lam is an addictions physician. "On the Ravine" tells the reader a great deal about the fentanyl crisis which is the subject of a great deal of political discussion in today's world. The truth is that I was happier in my ignorance. Reading the novel for me as a painful chore.
Dr. Chen is involved in two conflicts. First, he has to avoid falling in love with Claire, a patient who is a classicalist violinist. Second, he must conduct a field test for a pharmaceutical company which has developed a new drug to be used in the treatment of drug addicts. Chen manages to tell both stories very well.
Claire's tale is particularly touching. Lam obviously knows and loves classical music very well. His descriptions of Claire's glissandos, pizzzicatos, spiccatos and rubatos are exquisite. Chen like the author is clearly a lover of classical music. The reader understands why he starts to fall in love with Claire and worries that he might her lover. Lam also brilliantly describes Claire's ups and downs as she tries to fight her addiction.
The second plot is also presented very well. Dr. Chen is the founder of Varitas a firm that conducts trials of new drugs. He remains a minority shareholder and as consultant still directs the field trials. Dr. Chen hopes that at some point he will be able to take Varitas public and become rich.
Dr. Chen gets himself into entanglements with Varitas. Despite his status as a third-party consultant, he is still in real terms directing the operations of Varitas. In addition, he is recruiting test participants from his personal case load. Finally, he has become the lover of Bella who is an executive with Omega a pharmaceutics manufacturer that has developed a drug that Varitas will test. Bella clearly wants a successful field trial.
Ultimately Dr. Chen fails ethically. He never has an affair with Claire and thus maintains appropriate distance from his patient. Unfortunately his conduct with the Varitas-Omega drug trial is less honorable. When Chen first sees problems in the trial with the drug, he decides to resign as the director of the trial. This way Chen avoids legal trouble but in fact he ought to have halted the trial given what he had observed.
"On the Ravine" brilliantly portrays the worlds of opioid addiction, the treatment of addiction and the developed of pharmaceutical tools. However, it is also devoid of hope. I enjoyed much more the other books by Lam that I have read.
"On the Ravine" is above all topical. It gives the reader the a look behind the headlines. Like his protagonist Dr. Chen, Lam is an addictions physician. "On the Ravine" tells the reader a great deal about the fentanyl crisis which is the subject of a great deal of political discussion in today's world. The truth is that I was happier in my ignorance. Reading the novel for me as a painful chore.
Dr. Chen is involved in two conflicts. First, he has to avoid falling in love with Claire, a patient who is a classicalist violinist. Second, he must conduct a field test for a pharmaceutical company which has developed a new drug to be used in the treatment of drug addicts. Chen manages to tell both stories very well.
Claire's tale is particularly touching. Lam obviously knows and loves classical music very well. His descriptions of Claire's glissandos, pizzzicatos, spiccatos and rubatos are exquisite. Chen like the author is clearly a lover of classical music. The reader understands why he starts to fall in love with Claire and worries that he might her lover. Lam also brilliantly describes Claire's ups and downs as she tries to fight her addiction.
The second plot is also presented very well. Dr. Chen is the founder of Varitas a firm that conducts trials of new drugs. He remains a minority shareholder and as consultant still directs the field trials. Dr. Chen hopes that at some point he will be able to take Varitas public and become rich.
Dr. Chen gets himself into entanglements with Varitas. Despite his status as a third-party consultant, he is still in real terms directing the operations of Varitas. In addition, he is recruiting test participants from his personal case load. Finally, he has become the lover of Bella who is an executive with Omega a pharmaceutics manufacturer that has developed a drug that Varitas will test. Bella clearly wants a successful field trial.
Ultimately Dr. Chen fails ethically. He never has an affair with Claire and thus maintains appropriate distance from his patient. Unfortunately his conduct with the Varitas-Omega drug trial is less honorable. When Chen first sees problems in the trial with the drug, he decides to resign as the director of the trial. This way Chen avoids legal trouble but in fact he ought to have halted the trial given what he had observed.
"On the Ravine" brilliantly portrays the worlds of opioid addiction, the treatment of addiction and the developed of pharmaceutical tools. However, it is also devoid of hope. I enjoyed much more the other books by Lam that I have read.
December 6, 2023
It comes through clearly that this novel is written by a medical doctor. The dilemmas faced by doctors dealing with patients who use websites and message boards to self diagnosis, treating addicts with empathy while protecting themselves, their staff and other patients, and negotiating the perceptions of the public and investors in regards to the vulnerable population that is his patient base that the physician main character does everyday ring true to life.
There were times that I had to put the book down and walk away as the scene was so true to life that it was painful. There were other scenes designed to make the reader uncomfortable, or assess their own privilege. One of the latter takes place in an expensive restaurant that is chosen to woo an investor. The menu has " the sustainability, the minimal footprint, sprinkling a kind of virtue to garnish and balance the richness of the meal."
During this meal the investor continues virtue signaling by "talking about the role of pharmacology in confronting, "systematic bias", "trauma", "colonialism""
In another paragraph he brings to mind the current problems with shortages of medications for those who need it by the privileged few who have the funds, or connections to access the limited supply. Ozempic is currently one of those medications. It also questions the disadvantaged who are part of drug trials, in this case, addicts, and who benefits the most from those medications.
There are many more themes to unpack in this book that can lead to a few hours of discussion. It is a short easy to read story for all of that.
I highly recommend.
There were times that I had to put the book down and walk away as the scene was so true to life that it was painful. There were other scenes designed to make the reader uncomfortable, or assess their own privilege. One of the latter takes place in an expensive restaurant that is chosen to woo an investor. The menu has " the sustainability, the minimal footprint, sprinkling a kind of virtue to garnish and balance the richness of the meal."
During this meal the investor continues virtue signaling by "talking about the role of pharmacology in confronting, "systematic bias", "trauma", "colonialism""
In another paragraph he brings to mind the current problems with shortages of medications for those who need it by the privileged few who have the funds, or connections to access the limited supply. Ozempic is currently one of those medications. It also questions the disadvantaged who are part of drug trials, in this case, addicts, and who benefits the most from those medications.
There are many more themes to unpack in this book that can lead to a few hours of discussion. It is a short easy to read story for all of that.
I highly recommend.
June 6, 2024
Well written, but also very difficult to read. Addiction is painful. Claire is not the typical junkie profile - classically trained musician, from a well off family, albeit neglected by her parents and feels inferior to her more musically talented sister. She is prescribed painkillers for a shoulder injury and not long after spirals into the world of illicit drugs. It's the opioid epidemic story we hear about on the news, but humanized.
Claire's story intersperses with that of Dr Chen (first appeared in Lam's short story collection, Bloodletting & Miraculous Cures, although it is evident in On The Ravine that there is no miraculous cure), who runs an addiction clinic in Kensington Market, Toronto. There's a significant portion of Chen's narration that deals with Big Pharma and I wasn't too interested in that. But the benefit of harm reduction, frailty of recovery/sobriety, and helplessness of those who care was really well done and gave me a new found appreciation for this complex social issue that we are unfortunately overwhelmed with in many cities in North America.
Claire's story intersperses with that of Dr Chen (first appeared in Lam's short story collection, Bloodletting & Miraculous Cures, although it is evident in On The Ravine that there is no miraculous cure), who runs an addiction clinic in Kensington Market, Toronto. There's a significant portion of Chen's narration that deals with Big Pharma and I wasn't too interested in that. But the benefit of harm reduction, frailty of recovery/sobriety, and helplessness of those who care was really well done and gave me a new found appreciation for this complex social issue that we are unfortunately overwhelmed with in many cities in North America.
March 17, 2023
Have you ever had the experience of deeply disliking an actor, because the character they play is such a dick (think: Alan Rickman or the kid who plays Joffrey in GoT)? Then recognizing that the strength of your dislike for the character is a testament to how talented the actor is.
That's kind of where I'm at with this book. It was tough to read at times with it's unflinching look at opioid abuse and withdrawal. I wanted to criticize the novel for being unnecessarily long, like did we really have to see a character get clean --> back slide --> get clean -->rationalize using again --> get clean -->almost OD, repeated again and again? But if I'm being fair, the answer is yes. Yes we did have to witness that endless cycle, because that's what drug addiction and abuse is like.
Everything that makes this novel tough to read is a credit to the writing. Take that as you will, and don't expect a feel good romp.
Thank you to #NetGalley for the ARC
That's kind of where I'm at with this book. It was tough to read at times with it's unflinching look at opioid abuse and withdrawal. I wanted to criticize the novel for being unnecessarily long, like did we really have to see a character get clean --> back slide --> get clean -->rationalize using again --> get clean -->almost OD, repeated again and again? But if I'm being fair, the answer is yes. Yes we did have to witness that endless cycle, because that's what drug addiction and abuse is like.
Everything that makes this novel tough to read is a credit to the writing. Take that as you will, and don't expect a feel good romp.
Thank you to #NetGalley for the ARC
May 12, 2023
I wanted to like this book more but the intense sadness and futility I felt from the story just made me so heartbroken. I actually had to stop listening to it several times as the anticipation of another distressing situation made me apprehensive. But it was fantastic storytelling.
I already thought that the people who work with addicts and homelessness were incredible people but this book really solidified how impressive it is to still keep hope and still offer help, no matter how many times it is requested.
I already thought that the people who work with addicts and homelessness were incredible people but this book really solidified how impressive it is to still keep hope and still offer help, no matter how many times it is requested.
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