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A killer intoxicated by pain. Should Alex Madison stop her—or save her?

Across London, hospital patients are dying—in shockingly unnatural circumstances. A sadistic young woman is targeting them as they lie helpless in their beds, eking out every last sensation of pain as their lives ebb to an excruciating close.

The killer is a sadist, but careful too, so the police bring in forensic psychologist Dr Alex Madison to track down what is clearly an extraordinary and damaged mind. For Alex, the case has a personal resonance he can’t reveal: he knows pain and addiction all too well, and must fight to control his own downward spiral long enough to stop the killer’s campaign of cruelty.

As Alex closes in on the killer, it becomes clear that there are darker forces at work, and a connection to his previous case ignites his worst fears. When he uncovers the shocking truth behind the killer’s motivations, Alex must decide: should he pursue the police’s version of justice—or hunt down the sinister organisation that has warped another soul?

328 pages, Kindle Edition

First published November 7, 2019

312 people are currently reading
1662 people want to read

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Adam Southward

9 books83 followers

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5 stars
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102 (13%)
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Displaying 1 - 30 of 59 reviews
Profile Image for Matt.
4,836 reviews13.1k followers
October 24, 2019
First and foremost, a large thank you to NetGalley, Adam Southward, and Amazon Publishing UK for providing me with a copy of this publication, which allows me to provide you with an unbiased review.

When provided this advanced copy of the book, I wanted to get the full reading experience, so I turned to the series debut for some context. Devouring and thoroughly enjoying that piece, I knew that Adam Southward would be an author I would be adding to my ongoing reading list, with his captivating plot and well-paced narrative. It has been a year since Dr. Alex Madison handled a major case from the Met. While that one did not turn out as well as he expected, he has returned to consult once again. This case is a little different, but just as baffling. CCTV footage shows someone sneaking into the A&E of a London hospital and inflicting a great deal of pain to a waiting patient, so much so that it leads to an excruciating death. It would seem that this is not the first case of such an attach around London hospitals, but no one is entirely clear who this person is or what their motive could be. On the flip side, the reader is introduced to Mia Anastos, a young woman who can feel no pain, but revels in seeing it inflicted on others. She hides in the shadows and professes that she is on a mission to seek revenge for her pain. Mia’s targeted victims are only the first step in this complex web, as Madison finds her name on a list that matches her description. While Mia evades capture, she is being controlled by a larger group with hopes of neutralsing Dr. Madison themselves. As the psychology of pain comes to the forefront, Madison has a personal life in tatters that requires his additional attention. A great second novel in the series that keeps the reader hooked until the final reveal, leaving them begging for more. Adam Southward has great control over the series and its characters, tapping into the psychological and opening new areas of interest to the reader. Recommended to those who love quick thrillers, particularly the reader who finds matters of the mind of interest.

I powered through the first novel, in hopes that it would hold my attention enough to want to get to this ARC in quick order. Mission accomplished, as Adam Southward is able to mix a well-crafted thriller with strong psychological themes to keep the reader curious throughout. Alex Madison remains an intriguing character, easily liked by the reader. He is on point when it comes to his private practice and work with the police, though some find his insights too hard to comprehend or off the wall, thereby dismissing him. In a personal life that is anything but in order, Madison is forced to wrestle with a dark secret of his own, while trying to track down where to turn next in this highly unusual case. His relationship with his daughter is addressed yet again, as is the strained connection to his ex-wife. Madison has a great deal of growth to go and one can hope Southward will keep readers informed as the series grows. Other characters help to augment the excitement in this book, both with the case and through subplots that Southward uses to cut the tension. One can hope there will be some repeat appearances, as Alex Madison seems to have clicked its some and clashed with others. Southward uses a quick narrative, permitting the reader to learn a great deal in short order. The pain them resonates throughout and kept me wondering as the narrative built-up to a big reveal. Southward has proven he can handle psychological thrillers and police procedurals that mesh together effectively. I cannot wait to see what else is to come for Southward and Dr. Alex Madison.

Kudos, Mr. Southward, for another great ‘single day’ read. I am eagerly awaiting your next literary idea, but will be as patient as I must.

Love/hate the review? An ever-growing collection of others appears at:
http://pecheyponderings.wordpress.com/

A Book for All Seasons, a different sort of Book Challenge: https://www.goodreads.com/group/show/...
Profile Image for Louise Wilson.
3,663 reviews1,690 followers
November 5, 2019
Alex Madison #2

Alex Madison is a forensic psychotherapist. He is working on a new case alongside Detective Laurie. He is trying to help the police to find out who is murdering the patients in hospital. Mia does ot feel pain but she likes to inflict it I others who are already suffering. It quickly becomes clear that there is much more to this. Alex has his own problems. He's currently going through a messy divorce along with a fee other things.

Once again, I did not know this book was part of a series. Although there are references to the first book, it doesn't put you off enjoying the story. I've never heard of people who like to inflict more pain being an addiction before. There are some gory and stomach churning descriptive moments. The pace is fast and it did hold my attention from the beginning. The story is told from Alex perspective. The tension builds throughout the story. I don't know how I missed the first book in this series, ut i will need to read it before i read anymore i this very promising series.

I would like to thank NetGalley, Amazon Publishing UK and the author Adam Southward for my ARC in exchange for an honest review.
Profile Image for Jim C.
1,782 reviews36 followers
November 11, 2019
I received this book thru a Goodreads giveaway in exchange for a honest review. I would like to thank the author and the publishing company for their generosity.

This is the second novel of a series but it can be read as a stand alone. In this one, we follow a young girl that is addicted to the suffering of others. She visits those already in suffering and adds to it. The police are searching for this suspect and they utilized a psychologist in their search.

I believe this is the second published book by this author and if this book is any indication for this author he has bright career to look forward to. I would classify this book as part psychological thriller and part medical thriller. Right away I was interested in the proceedings and I wanted to find out about our suspect and what her motivations were even when she was acting out in a sadistic and graphic way. The main character, Alex, is interesting too as he assisting the police but he is flawed also as he has problems too. I liked how this book touches upon unsupervised medical research and also upon whether the antagonist is responsible for her actions or the actual culprits the people who made her what she is. Throughout I thought this was going to be a five star rating but the ending didn't do it for me. The author is making this part of an overall arc and I didn't care for that. I believe this should have been a self contained story with all the plots being resolved.

This was my introduction to this author and I am impressed. I am so impressed I will read the first book in this series even though it is not needed for this offering. I will also be on the lookout for future books in this series as I am more than interested in the main character and his future adventures.
Profile Image for Kalyn✨.
537 reviews88 followers
November 10, 2019
Ooh, it seems I have an unpopular opinion regarding this one! Please keep in mind that Southward has clearly done something right to conjure all of these shining reviews, so my little black sheep opinion (which isn't really all that negative, anyway) should be taken with a grain of salt.

There's no doubt Southward is a talented author and the plot is super unique, but I felt like it could've been shorter. Is that really just me? I'm generally a pretty fast reader, yet it took me nearly a month to finish this book. A month! I enjoyed reading it when I got around to it, but as soon as I put it down I'd just.. forget to pick it back up again. When I'd finally remember, I'd be sitting there expecting the ending to come up since it felt like I'd been reading it for aaages, only to see I'm just halfway through.

The story brings up a really interesting moral dilemma which I haven't really thought of before. Should we punish somebody who continues to do something they know is wrong, or treat the factors that made them more inclined to do those wrong things? Both? It was cool to see how different characters interpreted it and how they came to their own conclusions, especially given their differing experiences with addiction and whatnot.

Overall, it was an okay read, but I won't be continuing on with the series. I do recommend you give it a try if you find the synopsis interesting, though!

A big thank you to the publisher, Amazon Publishing UK, for allowing me to read this title in exchange for an honest review.
Profile Image for Lisa Jenkins.
144 reviews6 followers
October 30, 2019
Thank you NetGalley for the ARC of pain by Adam Southward. This book with people dying in hospital helpless to stop it is one of my worst nightmares so when I read the plot for this book I was almost to freaked out to request it but i did and I’m sure glad I did. It freaked me out but was such a good suspenseful book.
Profile Image for Jannelies (living between hope and fear).
1,308 reviews194 followers
November 19, 2019
Finished the book in a few short sittings, because it is hard to put down - except for the last 10% or so. The story is told from the viewpoint of Alex himself, and a young woman named Mia who doesn't know or understand why she does what she does. She inflicts pain to people in a very gruesome way. If you cannot stand graphic descriptions of torture, don't read this. I just skipped over them because in the end, the victim is always dead. But who is the real victim here? Mia wasn't born this way. Slowly Alex tries to find the real story, more hindered than helped by the fact that the police wants them to help but don't believe what he is learning. More so, this whole story apparently has something to do with Alex' past, but we only learn that at the end of the book.
And that is why I gave this book 3 stars instead of 4; the pace is very high in the story and I think, after reading reviews of the first book in this series, the author did a much better job, but in the last part of the book there is a lot of talking and explaining and it feels a little rushed.
I'm actually looking forward to the next book in this series because I would like to follow this author's progress.

Thanks to Netgalley for a digital review copy of this book.
30 reviews
November 17, 2020
Bonkers

Pulp fiction. Story is OTT, characters are cardboard cutouts. Only character with a real personality is the main one. And he comes across as a bit of...hmm not totally unlikeable, but a bit of a zoob. He doesn't seem to solve cases, he accidentally falls into the lap of the killers, does some amazing SAS/ marine stuff and walks away. Ludicrous.
Profile Image for Julie Howard.
129 reviews1 follower
January 12, 2020
This was a good read. Some descriptive sick things in it the made me go "eeeeeeek". Fascinating concept of this happening, even know I know it's fiction.
I enjoyed this one a lot more than the first one, "trance" I found it faster paced and more interesting.
Profile Image for Lauren.
843 reviews6 followers
August 29, 2022
(Rating 2.5) —- ***SPOILERS*** The main thing I can’t get over is how cringe Alex’s dialogue and thoughts are about the women he works with. I thought this with the last book but it’s even worse in this one. He just has really creepy thoughts about Laurie, not really sexual thoughts but just really obvious ones. He’s always wondering if she is flirting with him, literally from the second they meet. He constantly has strange off the cuff comments about her to make it obvious he is interested in. And I really don’t know why these women are attracted to him!!! He is an out of shape, shallow, drug addicted, divorced father who cheated on his wife!!!! He’s not funny or kind or sexy. I guess he’s smart but doesn’t seem smarter than any one else. It’s only that everyone keeps saying how smart he is but he rarely doesn’t anything intelligent. He just sort of stumbles upon things instead of figuring things out in a smart way.

Also, the ending didn’t make any sense to me at all! Why did he let Mia go?!?!? She was a serial killer and evil - whether it was her fault or not - so to just let her go hoping that she had changed is ridiculous!!!!!

I didn’t hate the book though. The original concept is still interesting and I like that it’s still threaded throughout this book.
Profile Image for Sue Watson.
603 reviews1 follower
May 22, 2020
Pain in so many ways

It is something that we each experience--physical, mental, spiritual. We all deal with it in different ways, all too often making it difficult for us to understand other ways. You see pain management clinics aisles of medicines to help relieve pain, holistic promises of release from pain. Facing the amount of pain the focus of this plot faces is not for the faint of heart. The first couple of chapters will give you an idea of the pain she deals with. But there is so much more. This is the second Alex Madison book I've read and I look forward to reading more.
Southward has given us a protagonist who is intelligent, who is strong in some ways, but broken/weak in others. He recognizes some of his faults, but not all. He wants to work on some of his problems, but like so many can find reasons to procrastinate. Very human! I look forward to where his experiences take him and I hope to see his character growth.
Profile Image for Pogo Dragon.
149 reviews3 followers
November 2, 2023
Am I the only person who thought this book was basically exactly the same as the first in the series?

Some variation in the nature of the baddie, main protagonist the only one who recognises what's going on, police who are vaguely sketched in but not really decently fleshed out, nonsensical over all conceit.

It's as though the author got one good idea and went for it a second time. And so much 'tell' rather than 'show'.
737 reviews19 followers
November 22, 2019
Nov 2019. Right at the beginning, soooo curious what makes Mia "tick". Who made Mia into a killer ? I couldn't wait to find out what makes her commit these brutal killings. Not for the faint of heart due to the details of some of the killings. Lots of action and the story rolls along very quickly. The first book in the Alex Madison Series, Trace, received 5 Stars from me.
Profile Image for Samantha Bowman .
271 reviews2 followers
February 6, 2021
Such an engaging medical thriller. I read a lot of this genre and this story was very original. The characters are likeable and the plot was well paced. Macabre at times which made my inner horror fan happy. Highly recommend!
54 reviews1 follower
January 16, 2025
Addiction at it’s most extreme

The 2nd book with Dr. Alex Madison centers on a woman addicted to pain. Intriguing premise, and weaves in some characters from the first book. Questions still remain setting up book 3. Wish more questions had been answered-
Profile Image for Pam Devine.
586 reviews11 followers
December 30, 2025
Jeepers this book had me cringing at times. The way the protagonist inflicted pain on those who died had me a little shocked but this was the point of their story. The investigation moved along well and the plot was well thought out. Recommended.
228 reviews2 followers
June 9, 2020
I finished it but it was a disappointing ending. The primes of the book was interesting but the main character si so pathetic the story dragged.
12 reviews
August 7, 2020
I really enjoyed this book. This is Alex Madison #2. Characters are being developed - and are interesting enough that I want to read more in the series. I have already ordered #3.
Profile Image for Kat M.
5,193 reviews18 followers
September 27, 2020
this was a really interesting read, I liked how different it was from other mystery novels. The characters were great and I really enjoyed reading this.
Profile Image for Karen Roth.
166 reviews
January 9, 2021
Yet another single word title book I had to locate via Author!!!!
Goodreads you suck!!!!
I only utilize you as you are a good way to list book reading, but your IT dept needs help!
Profile Image for Susanna S.
25 reviews1 follower
June 30, 2022
fantastic read!

There’s nothing like Adam Southward books. Unique, clever and almost as addicting as the characters own addictions. Pick it up, but you won’t put it down!
Profile Image for Janell A Sluga.
129 reviews1 follower
January 30, 2023
interesting story

This is an interesting tale of medical science and how it can go wrong. The characters are likeable and I look forward to reading more by this author.
Profile Image for Lori Poole.
228 reviews
July 29, 2023
Quick read—good summer reading. This book (and character) would make a good Netflix series = possible option once the SAG writers are off strike.
1 review
November 27, 2025
you will be surprised

I was surprised how much I enjoyed reading this book. Well written with an interesting plot and an ending leaving you wanting more.
4 reviews
April 9, 2020
Intriguing

“Pain” started off slowly, but took off at break neck speed as I continued through the pages. Mia is an intriguing character and the entire storyline makes me wonder if we will see connections between Mia and Victor’s stories further on in the series. If you’re looking for a psychological thriller, definitely give this book a try.
15 reviews
March 22, 2020
Fabulous story and folow up to Trance

Corruption and arrogance in high places lead to evil experiments on innocents in the civilised wkrld of London. Very satisfying read.
Profile Image for Lauren Johnson.
43 reviews7 followers
March 9, 2020
3.5 ⭐️

This is the second book in the Alex Madison series which follows the life of a psychologist working alongside the police force to catch a murderer. We have a young woman who’s been abducted and forced into a scientific trial that lives up to the books title.
The book starts strong with great character building and suspense for what will happen next but unfortunately the middle dragged like cement on your feet. The middle chapters just repeat back and forth for way too long to be enjoyable but the pacing picks up by around the 80% mark. The ending had a “twist” that was very obvious in my opinion but it didn’t take away from it ending the book with a tight little bow. It was sort of odd to see such a happy ending to a thriller but I felt satisfied that it at least fit the story.
Overall a nice read and I’ll be checking out future books in the series.



I received this book for free in exchange for my honest review. Thank you to the author and Goodreads.
Profile Image for Kathryn.
233 reviews
March 13, 2020
I received this ebook from Goodreads Giveaways.

This book was just okay for me. Had a hard time finishing the book it just kind of died off in the last 25%.
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