What do you think?
Rate this book
Burke #13
Pain Management
Burke is back, but still lurking in the shadows, unable to return home. He is prowling the unfamiliar streets of Portland, Oregon, in search of a runaway teen. By all accounts, Rosebud Carlin is a happy, well-adjusted girl. She doesn't fit the profile of the runaway kids Burke knows so well�and once was. But there's something about her father�
Burke knows the street script, but the actors are all strangers. Cut off from his family and his network of criminal contacts, Burke is forced into a dangerous alliance with a renegade group dedicated to providing relief to those in intractable pain by any means necessary. A bargain is struck, and the fuse is lit. Heart-stopping and hard-hitting, Pain Management is the latest bout in Andrew Vachss's thrilling reign as undisputed champ of brass knuckles noir.
Burke knows the street script, but the actors are all strangers. Cut off from his family and his network of criminal contacts, Burke is forced into a dangerous alliance with a renegade group dedicated to providing relief to those in intractable pain by any means necessary. A bargain is struck, and the fuse is lit. Heart-stopping and hard-hitting, Pain Management is the latest bout in Andrew Vachss's thrilling reign as undisputed champ of brass knuckles noir.
307 pages, Paperback
First published January 1, 2001
20 people are currently reading
368 people want to read
About the author
Andrew Vachss
138 books890 followersAndrew Vachss has been a federal investigator in sexually transmitted diseases, a social-services caseworker, a labor organizer, and has directed a maximum-security prison for “aggressive-violent” youth. Now a lawyer in private practice, he represents children and youths exclusively. He is the author of numerous novels, including the Burke series, two collections of short stories, and a wide variety of other material including song lyrics, graphic novels, essays, and a “children’s book for adults.” His books have been translated into twenty languages, and his work has appeared in Parade, Antaeus, Esquire, Playboy, the New York Times, and many other forums. A native New Yorker, he now divides his time between the city of his birth and the Pacific Northwest.
The dedicated Web site for Vachss and his work is
www.vachss.com. That site and this page are managed by volunteers. To contact Mr. Vachss directly, use the "email us" function of vachss.com.
The dedicated Web site for Vachss and his work is
www.vachss.com. That site and this page are managed by volunteers. To contact Mr. Vachss directly, use the "email us" function of vachss.com.
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 41 reviews
April 27, 2019
Still in mourning from death in the last novel, Burke is living with Gem in Portland, and getting bored when she finds him a missing person case. A well-behaved, intelligent teenage girl has run away from her home, and the police seem disinterested. Her frantic father hires Burke, and much of the book is Burke's unorthodox way of finding people and the truth. Meanwhile, the police are seeking a serial killer of prostitutes and Burke his expertise to a local cop friend of Gem's. We meet Ann O. Dyne, who is working to protect the hookers and also fanatically dedicated to helping ease debilitating pain for the sick and dying. Again seeking to trade favors, Ann introduces Burke to a local thug, who runs many of the hookers and Burke takes active measures to stop the killings. Nobody seems to believe that Burke won't return the runaway to her father, if she has a bona fide reason for her disappearance. The reason is a surprise. However, Burke needs to get back to his NY-based family.
October 10, 2022
I am seriously suffering memory loss rereading these books from a decade ago. I am re-experiencing this series in the Audible format while following along with e-books. Once again this story seems to have only a very little bit to do with the pedophile issue that I always associate Burke with. And this book takes place totally in Oregon with hardly any connection with or even reference to his family in New York City.
————————
I like a book with really short chapters. Pain Management meets the short chapter requirement.
Evidently I am not going to read any literature for a while yet. I already have my next two books stacked on my desk: The Sins of the Fathers and Mystic River. I am looking forward to reading both of them for the first time. In fact it will be my first exposure to the authors Lawrence Block and Dennis Lehane. But I don’t think they count any more as literature than this book.
This is my third Andrew Vachss book in a row, the twelfth book in the Burke series. My only excuse for the excess of Vachss is that at the end of each book there has been an uncertain future for Burke and I couldn’t wait. Like the Saturday episodes at the movies that forced you to come back the next week. Also this is an eighteen book series that it seems like I have been reading forever and I want to feel I am making some headway. And once I start a Burke book I find it hard to put down.
In the last book Burke took the path less traveled. He chose to remain in Portland, Oregon, rather than return to New York City and his large family of unique characters. He also decided he was going to live with Gem, the woman he met in the last book. It would be hard to say that he was settling down however. It would also be hard to say that he was happy. Living the life of crime in Portland is not the same as living the life of crime in NYC. Not surprising. The chances of him making Portland a success seem slim. But looking ahead, I see the release the first book of a new Vachss series this year (2013): Aftershock . It has new characters and is set in Oregon so he must have some attraction to the northwest.
In Portland, Burke is Burke-lite out of his element. He has the ability to think quickly no matter the situation. He has a good comeback for everything, sometimes serious and sometimes sarcastic. There is nothing he can’t be and nothing he doesn’t know. How can that be? Vachss is writing all the dialogue and creating all the situations; of course Burke is omniscient, the book would not be as entertaining if he was not. Vachss makes Burke exactly like he needs him to be to make the book work. We do not expect a comic book character like Burke to be totally consistent.
At the beginning of the book Burke has a disfigured face and one good eye. Throughout the book the man seems to have no facial or ocular issues. Poof! Problems gone. Not a part of the story… the differently abled rights people must love it: a disability that doesn’t rear its ugly face.
Most of the book is about Burke’s search in Portland for a missing girl. Although the people Burke finds in Portland do not rise to the same level as his family in New York City, some are interesting and deserve notice as good storybook characters.
And, even on the west coast, Vachss can coin some clever similes: … as unused as a pawnbroker’s heart… as empty as a senator’s conscience ... And interesting and fun word combinations: . . . an acid rain of sadness falling inside me . . . He watched me approach his table like I was a bad biopsy result . . . like a truthful telemarketer.
You can always count on Burke to save the lost child and to resort to violence to do good things. There are clues right from the start that Oregon is not a good match for Burke. The biggest problem with Portland is that it is not even close to being NYC. And it is obvious that his relationship with Gem is undermined by too much face time. Burke is really not a nice enough guy to live with anyone. He says, “My family, I . . . need to be there with them. Not next door or anything. I don’t have to see them every day. But I’ve got no . . . life here.”
But Burke is rightly called a hunter. His terrain is NYC. He says, “Wherever I’ve gone, the games are always the same.” But “I don’t have people in Portland” and “I kept thinking about . . . going back home.”
Burke is a professional “man for hire.”
He stops a serial killer, solves his missing person case, assists in a drug hijack, reconciles his relationship with Gem and then is “gone for good.”
Vachss never had any intention of taking Burke away from his NYC family. While it has been interesting to see him in a new setting, I am glad to see him returning to his familiar haunts in the City.
This is a four star book for me without much question. It kept me entertained and guessing from beginning to end. And like I said at the start, I like short chapters.
————————
I like a book with really short chapters. Pain Management meets the short chapter requirement.
Evidently I am not going to read any literature for a while yet. I already have my next two books stacked on my desk: The Sins of the Fathers and Mystic River. I am looking forward to reading both of them for the first time. In fact it will be my first exposure to the authors Lawrence Block and Dennis Lehane. But I don’t think they count any more as literature than this book.
This is my third Andrew Vachss book in a row, the twelfth book in the Burke series. My only excuse for the excess of Vachss is that at the end of each book there has been an uncertain future for Burke and I couldn’t wait. Like the Saturday episodes at the movies that forced you to come back the next week. Also this is an eighteen book series that it seems like I have been reading forever and I want to feel I am making some headway. And once I start a Burke book I find it hard to put down.
In the last book Burke took the path less traveled. He chose to remain in Portland, Oregon, rather than return to New York City and his large family of unique characters. He also decided he was going to live with Gem, the woman he met in the last book. It would be hard to say that he was settling down however. It would also be hard to say that he was happy. Living the life of crime in Portland is not the same as living the life of crime in NYC. Not surprising. The chances of him making Portland a success seem slim. But looking ahead, I see the release the first book of a new Vachss series this year (2013): Aftershock . It has new characters and is set in Oregon so he must have some attraction to the northwest.
In Portland, Burke is Burke-lite out of his element. He has the ability to think quickly no matter the situation. He has a good comeback for everything, sometimes serious and sometimes sarcastic. There is nothing he can’t be and nothing he doesn’t know. How can that be? Vachss is writing all the dialogue and creating all the situations; of course Burke is omniscient, the book would not be as entertaining if he was not. Vachss makes Burke exactly like he needs him to be to make the book work. We do not expect a comic book character like Burke to be totally consistent.
At the beginning of the book Burke has a disfigured face and one good eye. Throughout the book the man seems to have no facial or ocular issues. Poof! Problems gone. Not a part of the story… the differently abled rights people must love it: a disability that doesn’t rear its ugly face.
Most of the book is about Burke’s search in Portland for a missing girl. Although the people Burke finds in Portland do not rise to the same level as his family in New York City, some are interesting and deserve notice as good storybook characters.
And, even on the west coast, Vachss can coin some clever similes: … as unused as a pawnbroker’s heart… as empty as a senator’s conscience ... And interesting and fun word combinations: . . . an acid rain of sadness falling inside me . . . He watched me approach his table like I was a bad biopsy result . . . like a truthful telemarketer.
You can always count on Burke to save the lost child and to resort to violence to do good things. There are clues right from the start that Oregon is not a good match for Burke. The biggest problem with Portland is that it is not even close to being NYC. And it is obvious that his relationship with Gem is undermined by too much face time. Burke is really not a nice enough guy to live with anyone. He says, “My family, I . . . need to be there with them. Not next door or anything. I don’t have to see them every day. But I’ve got no . . . life here.”
But Burke is rightly called a hunter. His terrain is NYC. He says, “Wherever I’ve gone, the games are always the same.” But “I don’t have people in Portland” and “I kept thinking about . . . going back home.”
Burke is a professional “man for hire.”
You know the difference between a crazy man and a professional? The big difference is, the crazy man, doesn’t have a sane reason for what he does. It may be a sane thing he’s doing, you understand. But where he comes up short is on the reason . . .
He stops a serial killer, solves his missing person case, assists in a drug hijack, reconciles his relationship with Gem and then is “gone for good.”
Vachss never had any intention of taking Burke away from his NYC family. While it has been interesting to see him in a new setting, I am glad to see him returning to his familiar haunts in the City.
This is a four star book for me without much question. It kept me entertained and guessing from beginning to end. And like I said at the start, I like short chapters.
June 23, 2010
Quite simply a magnificent novel that borders on being atrue work of art and genius. I have no idea how Vachss can write something of this quality. Don't approach this thinking you can simply sit back and be entertained as Vachss does not operate like that - this is a book designed to get the grey matter stirring and you'll find your mind wandering off at tangents time after time - normally a bad sign in abook but in this case it's most definitely not.
December 22, 2008
Vacchs is a keeper. Man goes deep on morality, a code for living, and the need for that to live well. Purposefully and rightly. Even if the main character's a criminal. When he cuts off the fist two stretches of the index fingers of a guy, he cauterizes them with his mini-blow torch, and the guy had cut a lot of hookers who hadn't paid up 20 bucks a night for 'protection' - someone else's racket who he later takes out -instantaneously and without remose or a second's thought- when the 'kingpin' of this petty hooker shakedown threatens his partner with a gun.
Code. Hemingway righteous. Not everyone's tea, but strong drink, for sure.
This one has a lot to do with family, and the hypocricy of the - well, don't want to spoil it.
Burke in Oregon, 2 or 3rd book with Gem. Still has the stuff in terms of laying out the blues: "I bowed slightly, the way Mama taught me a million years ago. Done properly, the gesture crosses cultures, conveying respect without submission."
"Magic Sam's 'What Have I done Wong?' poured out invisible speakers, like they were playing my walk-out music for a fight.
It looked like someone had raided the table-and-chairs section of a Goodwill warehouse and scattered teh pickings all aroudn the trailer at random: wood, plastic and everything in betwee, all sizes and shapes. All they had in common was that nothing matchied. Chirstmas lights were strung above, interspersed with blue bug-zappers. The whole scene looked like something you'd find any summer night on capturedd-for-the-moment vacant lots in cities from Detroit to Dallas. When a cook's got a rep for /real/ barbecue, there's no need for a permanent location. That's what they mean by a 'following'. ....
Chicago kept coming to Portland through the speakers. Luther Allison's 'The Skies are Crying.' Eddie Boyd's '3rd Degree.' Susan Tedeschi's 'It Hurt So Bad.' ....
"Isreal makes the best barbecue in the world," she said.
It was too dark to see her eyes, so I focused hard on the pale oval of ther face, expecting some lame joke about Jews and pork...at best.
She caught my look and blew it off with, "He's about hundred years old...Isreal. Funny name for a black guy, huh? All anyone knows is that he's from Cleveland. He sets up in different places all the time. Word gets out, people come from all over. Then he just disappears again."
"Like you."
"Just because you don't know where to look doesn't mean someone's disapeared."
....I did the math. The kind you do all the time in prison. Not counting the days-that's okay for a county-time slap, but it'll make you crazy if you've got years to go on a felony bit. The /balancing/ math. Like when you're short-getting out soon. What you want to do is stay down, out of the way, not do anything that would mess up your go-home. But word gets around the tier like flash fire. And some guys who wouldn't have tried you when you still had heavy time to serve suddenly get brave. So you have to dance. Stay hard enough to keep the wolves off you, but not do the same kind of things you did to send that message when you fist came in.
Inside, if you're /with/ people, everything's easier. Same out here. That was part of the math. I didn't have people in Portland. ...."
and so it goes
Code. Hemingway righteous. Not everyone's tea, but strong drink, for sure.
This one has a lot to do with family, and the hypocricy of the - well, don't want to spoil it.
Burke in Oregon, 2 or 3rd book with Gem. Still has the stuff in terms of laying out the blues: "I bowed slightly, the way Mama taught me a million years ago. Done properly, the gesture crosses cultures, conveying respect without submission."
"Magic Sam's 'What Have I done Wong?' poured out invisible speakers, like they were playing my walk-out music for a fight.
It looked like someone had raided the table-and-chairs section of a Goodwill warehouse and scattered teh pickings all aroudn the trailer at random: wood, plastic and everything in betwee, all sizes and shapes. All they had in common was that nothing matchied. Chirstmas lights were strung above, interspersed with blue bug-zappers. The whole scene looked like something you'd find any summer night on capturedd-for-the-moment vacant lots in cities from Detroit to Dallas. When a cook's got a rep for /real/ barbecue, there's no need for a permanent location. That's what they mean by a 'following'. ....
Chicago kept coming to Portland through the speakers. Luther Allison's 'The Skies are Crying.' Eddie Boyd's '3rd Degree.' Susan Tedeschi's 'It Hurt So Bad.' ....
"Isreal makes the best barbecue in the world," she said.
It was too dark to see her eyes, so I focused hard on the pale oval of ther face, expecting some lame joke about Jews and pork...at best.
She caught my look and blew it off with, "He's about hundred years old...Isreal. Funny name for a black guy, huh? All anyone knows is that he's from Cleveland. He sets up in different places all the time. Word gets out, people come from all over. Then he just disappears again."
"Like you."
"Just because you don't know where to look doesn't mean someone's disapeared."
....I did the math. The kind you do all the time in prison. Not counting the days-that's okay for a county-time slap, but it'll make you crazy if you've got years to go on a felony bit. The /balancing/ math. Like when you're short-getting out soon. What you want to do is stay down, out of the way, not do anything that would mess up your go-home. But word gets around the tier like flash fire. And some guys who wouldn't have tried you when you still had heavy time to serve suddenly get brave. So you have to dance. Stay hard enough to keep the wolves off you, but not do the same kind of things you did to send that message when you fist came in.
Inside, if you're /with/ people, everything's easier. Same out here. That was part of the math. I didn't have people in Portland. ...."
and so it goes
June 21, 2008
Another great book by Vachss. The more I read his work, the better I like it.
February 5, 2018
Burke is away from his home turf. As always Vachss writes with page turning precision
September 11, 2021
I was interested to see what roll pain would play in this book. Burke, the main character, is a "man for hire." He can track people down, he can get rid of people, settle scores, things you can't hire licensed PI firms to do. Despite this, when it comes to certain things, particularly the protection of children and prostitutes, he has a very strong moral code.
Burke is approached to look for a missing teen. The police have written her off as a runaway and the PI firm the police recommended didn't turn up anything useful.
In his jaunts through the underworld Burke encounters Anne. Anne insists she can put Burke in contact with the missing girl, but she needs something from Burke first.
I'm never exactly clear if Anne is a doctor, nurse, social worker or concerned citizen who's gotten very involved. Her interest is in relieving pain, initiated by the uncontrolled pain leading up to her mother's death. Now she tries to help others get pain medication that doctors won't prescribe (the book was written before the opioid epidemic). Anne has sought out Burke because she believes he has the tactical skills to help her access a supply of drugs she can distribute to her network of patients.
In the midst of this Anne and Burke get involved in a few other side deals, in attempts to exchange for information they're looking for to assist with either of their end goals.
Burke isn't the sort of character I usually read, but he has been well developed. As characters, Anne and her network were a bit underdeveloped but his assessment of them remains interesting to me.
For some reason I thought it might be violent, but it didn't hold a candle to the Scandinavian murder mysteries (of which I was just as happy). I'm not sure if I'd seek others out, but it wasn't a waste of time.
Burke is approached to look for a missing teen. The police have written her off as a runaway and the PI firm the police recommended didn't turn up anything useful.
In his jaunts through the underworld Burke encounters Anne. Anne insists she can put Burke in contact with the missing girl, but she needs something from Burke first.
I'm never exactly clear if Anne is a doctor, nurse, social worker or concerned citizen who's gotten very involved. Her interest is in relieving pain, initiated by the uncontrolled pain leading up to her mother's death. Now she tries to help others get pain medication that doctors won't prescribe (the book was written before the opioid epidemic). Anne has sought out Burke because she believes he has the tactical skills to help her access a supply of drugs she can distribute to her network of patients.
In the midst of this Anne and Burke get involved in a few other side deals, in attempts to exchange for information they're looking for to assist with either of their end goals.
Burke isn't the sort of character I usually read, but he has been well developed. As characters, Anne and her network were a bit underdeveloped but his assessment of them remains interesting to me.
For some reason I thought it might be violent, but it didn't hold a candle to the Scandinavian murder mysteries (of which I was just as happy). I'm not sure if I'd seek others out, but it wasn't a waste of time.
May 7, 2019
It always amuses me when characters in long-running series end up in my hometown. Burke is a bit of a fish out of water as he lands in Portland, Oregon, but he soon manages to create a ramshackle crew to get some things done.
My only problem with this particular book was that there were just too many characters that I didn't like. The guy who hires Burke to find his runaway daugher: unlikable. The daughter herself: unlikable.
Vachss has also once again chosen to use his books to highlight a particular issue, and this one is about how people in pain can't get good painkillers. However reading this in the present, when we're in a well publicized opioid crisis, I'm not sure this subplot has aged well.
Still, it's a Burke novel so it's still entertaining to a point. I just think it should have been so much more.
March 19, 2025
I don't know how we went from one of the best Burke stories to one of the worst but here we are. Everything about this was just so hard to read. Gem went from perfect bubbly girlfriend/wife to just being weird and rude all the time with a cop boyfriend (?) on the side. There's a half-ass subplot of prostitutes going missing, some potential serial killer but the plot goes nowhere and doesn't even really move the story forward at all. It seems like every character that Burke meets by chance was connected to the missing girl and they just wanted leverage to get Burke to heist some pharmaceuticals. Turns out the daughter ran away because her dad was an informant for the government and not some idealistic leftist.
This entire review has been hidden because of spoilers.
June 15, 2023
Vachss can write his ass-off, and circles around most other authors, but as engaging as Burke stories can be, they don't always make a whole lot of sense.
In this one Vachss has gone back to interrupting virtually every sentence someone says, and while that won't always lose the reader, sometimes it will, and those losses are what makes things confusing.
My trouble was with the circumstances of the father/daughter relationship that Burke gets involved with.
I couldn't really make sense of that.
Overall though, a great story.
In this one Vachss has gone back to interrupting virtually every sentence someone says, and while that won't always lose the reader, sometimes it will, and those losses are what makes things confusing.
My trouble was with the circumstances of the father/daughter relationship that Burke gets involved with.
I couldn't really make sense of that.
Overall though, a great story.
December 24, 2023
A welcome departure from the typical Burke story. Out on the west coast, in Oregon, he's away from his family ("of choice"), all ex-cons or part of an underground network. He's enlisted to track down a missing girl, and resorts to more of a P.I. type role, discovering some secrets along the way. The ending doesn't quite live up to the rest of the story (not that unusual) -- more of a MacGuffin, a la Hitchcock, where the journey is more interesting than the destination, but a device is needed to keep the plot going.
July 5, 2017
As usual, Vachss delivers a solid thriller. After the events of Dead and Gone, Burke finds himself recovering in Portland, not able to go back to NYC, he takes on the search of a missing teenager. Of course, everything is not what it seems and the case takes a few turns.
As much as I enjoyed this, I missed Burke New York family( Max, Mama, Michelle, Mole and The Prof) Vachss has made those characters live and breathe and I felt their absence.
An enjoyable entry in a powerful series.
As much as I enjoyed this, I missed Burke New York family( Max, Mama, Michelle, Mole and The Prof) Vachss has made those characters live and breathe and I felt their absence.
An enjoyable entry in a powerful series.
October 15, 2018
Another pitch blck noir from Vachss. Burke is out of his element after the last book, but he's still trying to find kids in trouble as well as make money from whatever scams he can pull. Relatively straightforward storyline, albeit with an unexpected ending.
Reading Vachss work, I am forced to suggest that he is a true artist.
Reading Vachss work, I am forced to suggest that he is a true artist.
December 28, 2022
Sometimes, it's interesting to read about Burke out of his element (Blosssom, Down in the Zero). Less so this time. I'd forgotten about the references to Charles DeLint, and to Terri Windling's "Bordertown" series--other authors whose writing features young adults struggling with abuse and grief and rage and pain.
June 25, 2017
Not my favorite, but not bad. Some exciting subplots in Portland, but I want Burke back home.
October 24, 2018
Less exciting than most of Vachass's work. Burke in in Seattle so he doesn't have his usual group of friends to help out, he isn't connected, some whinging.
March 8, 2020
Quite a lumpy and disjointed affair. Worth persevering with but ultimately not one of his best. Vachss is an exciting and original crime writer but appears to have had a bit of an off day here.
March 27, 2020
There was a tendency to ramble.
January 19, 2022
Read in 2001. Good title for Burke book.
January 26, 2022
Fantastic book
I am on a mission to read all the “Burke” books. This is another one in the excellent series. Start with the first book, “Flood”
I am on a mission to read all the “Burke” books. This is another one in the excellent series. Start with the first book, “Flood”
September 28, 2022
Burke vs. Portland
July 5, 2019
Quintessential Burke
He’s not home, but he works to get back home. In the meantime, he does the job. Pansy is gone.
He’s not home, but he works to get back home. In the meantime, he does the job. Pansy is gone.
November 23, 2016
This entry in the Burke series started out really, really strong and then managed to fall off drastically, mostly due to several plot elements, including a side bar on pain medicine and a red herring about a tandem man/woman serial killer duo that never panned out. The initial elements, Burke looking for a runaway, started out promising, but then got seriously sidetracked. Add to the fact that a vibrant character from the previous novel, Gem, this time out becomes distant and obtuse, much in the same way that Vachss had once written initially startling Wolfe character. Here Gem just seems to pout and dismiss Burke after previously declaring that she was his "wife". Perhaps it all coalesces into Burke's inability to actually talk to women (with the exception of Pansy), but the immediate coldness and distance of Gem, as compared to her persona in the last novel, is startling and jarring, to say the least. The first part of the book is great detectiving, showing Burke's trials and tribulations with working in a new city (Portland), but the ultimate reveal is lackluster and a bit offputting, especially with all the great set-ups in regards to the urban fables of Charles de Lint and the underground comics of Madison Clell. Perhaps the serial killer red herring will manifest itself in the next novel, but if it doesn't, then it was just a frustrating deviation from the initial plot. Adding to some of the tension was an obvious soap-boxing in regards to medications given to the terminally ill. I applaud Vachss for using his books to hi-lite important subjects, but every once in awhile it feels like he's semi-fanatically preaching rather than educating (which is interesting, since he touches upon the mindset of fanatics within these very pages).
January 1, 2014
You've read all the stuff about what actually happens in Pain Management already, so let's not rehash any of that.
Vachss' novels appeal to a couple different types of readers: the surface dwellers, and the mission soldiers. No judgments intended or implied. For the surface dwellers, there is plenty of quality character development, noir action and twisty plot. Vachss ranks with the best in this area (Connelly, Lehane,Crais, Block, etc.). Some great new characters (let's all praise ANN O. DYNE!!! Hubba Hubba!!), and development of recent ones; we learn a lot more about Gem, and those around her, making her a worthy addition to the "family." When Burke goes into action, doing his thing, it reads cinematically. Personally, I love those aspects of Vachss' work, and Pain Management features lots of it.
For the mission soldiers, those that have been on board his bus for lo these many years, Vachss hopes that we think about how we take care of the terminally ill. Exposing the Nancy Reagan legacy, which rejects making addicts out of the dying at all costs, particularly the patient's comfort,Vachss refuses to accept dogmatism, particularly when the peace of mind of the individual suffers. Burke is the ultimate pragmatist, and God bless him for it.
The beauty of Vachss' writing is that as the novel rolls along, the reader gets sucked into the action, characters and dialogue. Then, after it's over, the light goes on, and it's like, "Oh wow!! I get it now!!" That's the joy of quality fiction. And make no mistake, Pain Management is Crime Fiction of the highest quality.
Vachss' novels appeal to a couple different types of readers: the surface dwellers, and the mission soldiers. No judgments intended or implied. For the surface dwellers, there is plenty of quality character development, noir action and twisty plot. Vachss ranks with the best in this area (Connelly, Lehane,Crais, Block, etc.). Some great new characters (let's all praise ANN O. DYNE!!! Hubba Hubba!!), and development of recent ones; we learn a lot more about Gem, and those around her, making her a worthy addition to the "family." When Burke goes into action, doing his thing, it reads cinematically. Personally, I love those aspects of Vachss' work, and Pain Management features lots of it.
For the mission soldiers, those that have been on board his bus for lo these many years, Vachss hopes that we think about how we take care of the terminally ill. Exposing the Nancy Reagan legacy, which rejects making addicts out of the dying at all costs, particularly the patient's comfort,Vachss refuses to accept dogmatism, particularly when the peace of mind of the individual suffers. Burke is the ultimate pragmatist, and God bless him for it.
The beauty of Vachss' writing is that as the novel rolls along, the reader gets sucked into the action, characters and dialogue. Then, after it's over, the light goes on, and it's like, "Oh wow!! I get it now!!" That's the joy of quality fiction. And make no mistake, Pain Management is Crime Fiction of the highest quality.
November 24, 2012
Definitely the weakest installment in the series I've read so far; Vachss brings Burke to unfamiliar territory (Portland) with less than stellar results. Gone are the rich characters we've come to know and love and in their place is a wide array of one dimensional personalities and an endlessly boring search for a teenage runaway. The payoff is weak (even by "later" Burke series standards) and is sure to rub a few people the wrong way. I'm a completist so I had to read this installment but in all honesty if you need one to skip this is it. And for a little bit of irony I'd like to point out that the only thing I liked about this book was a character by the name of Kruger, a "gentleman pimp" of the highest caliber. For anyone familiar with many of the issues and themes addressed in this series, a pimp, gentleman or no, would normally be the last person Vachss would glorify but Pain Management strays greatly from the formula and with semi disastrous results.
May 20, 2025
Burke is still living on the west coast with Gem & still mourning his losses. He's without "his family" & trying to start a new life while prowling around unfamiliar Portland, Oregon trying to find a teenaged runaway. She doesn't fit the usual profile of a runaway that he knows so well. There is just something about the father. . .
I didn't like this book as much as some of its predecessors, while still gritty, Burke seemed to be floundering too long & a few characters were unnecessary for the plot. I could've done without one of the subplots. Vaachss does a good job of shaking up Burke's "comfortable" life to get him out of NY, but its time for him to go back. I missed all the supporting characters that make these books better (Mama, Max the Silent, the Prof, Clarence, the Mole, & the rest). I still plan on finishing this series.
I didn't like this book as much as some of its predecessors, while still gritty, Burke seemed to be floundering too long & a few characters were unnecessary for the plot. I could've done without one of the subplots. Vaachss does a good job of shaking up Burke's "comfortable" life to get him out of NY, but its time for him to go back. I missed all the supporting characters that make these books better (Mama, Max the Silent, the Prof, Clarence, the Mole, & the rest). I still plan on finishing this series.
February 7, 2012
“Pain Management” (2001) finds Burke staying in Portland with Gem. He accepts a job–to find Rosebud, a teenage girl who disappeared from her home. She appears to be a runaway. But why? Operating in Portland, without the familiar New York cast of underworld characters–Max, Michelle, the Mole, Mama, Clarence, and others–Burke is just another private investigator, and this is just another mystery plot.
Burke uses this book to preach against restrictions on industrial-strength pain medicine for terminally ill people. They end up dying in agony, when drugs were available which could have kept them comfortable in their final days. Kind of a strange cause, but there you have it.
Burke uses this book to preach against restrictions on industrial-strength pain medicine for terminally ill people. They end up dying in agony, when drugs were available which could have kept them comfortable in their final days. Kind of a strange cause, but there you have it.
November 13, 2012
This is not one fo Vachss' better works. A bit clunky and tired, like the squeeking chassis of '71 Dodge Dart. The characters are more two-dimensional than his earlier works which led me here.(Flood, Strega) Sadly, although I really looked forward to this book, I found myself reading with weary contempt, not the grinding envy I expected. Oh well, there's 10 other Burke novels prior to this one I can still read!
February 29, 2016
Pain Management (Burke #13) by Andrew Vachss (Alfred A. Knopf 2001)(Fiction - Mystery) finds Burke in the Pacific Northwest cut off from his former life in NYC and allied with Samaritans who heist pain medications for the underprescribed. My rating: 4/10, finished 6/23/11.
December 6, 2007
Gritty fast read dealing with similar subjects (child abuse, loyalty, a different view of family, and virtue) that Vachss often deals with. Set in Portland, Oregon rather than New York. Rating 3 1/2.
Displaying 1 - 30 of 41 reviews