Central to the story are the good Dr. Berger, proprietor of a renowned clinic for migraine sufferers; Mrs. Watson, his patron, loyal supporter, and foil; and Ruth, a nurse with secrets whom Mrs. Watson brings in to spy on the doctor. Lurking in the background is the mysterious and missing Sarah, a former patient (and perhaps lover?) of Dr. Berger’s; the perverse P, to whom Sarah goes for relief and, unintentionally, sexual exploitation; and Orson, Mrs. Watson’s son, who may prove far nobler than we first think.

Loyd gives each member of this wide cast their due. Not a scene or description is wasted, and the writing is full of a sensual eroticism that ties the heightened senses and auras arising from migraine together with the thrill of arousal. If they don’t know how painful migraine actually is, readers might come away thinking it nearly orgasmic.

The author also eroticizes the clinic itself, located in the basement of an abandoned Brooklyn church. The coldness of the facility is offset by patients’ excitement over possibly finding relief from their agony. The beds, walls, and lighting combine to form a setting in which one may enter, release all fears and inhibitions, and find ecstasy. It’s no coincidence that much of the story’s action takes place below ground, away from the prying eyes of others.

Certainly, all kinds of relationships can bring pleasure and pain, including family relationships. Mrs. Watson, for one, is proud of her son but wary of his alliance with her half-sister. Sarah’s connection with P presents as almost spousal, at least until he pimps her out and humiliates her. And the doctor’s feelings toward his former wife — whose reliance on opioids leaves him vulnerable professionally — bring their own torment.

A secret — and the subsequent threat of blackmail — pulses beneath the action. (Is there anything more erotic than the frisson of danger that comes from a hidden scandal potentially being laid bare?) Although the whereabouts of Sarah forms the book’s main mystery, the lead characters each endure their own threat of exposure: the doctor over his failures with his ex-wife; she over her own failure to stop abusing drugs; and, of course, Sarah herself, whose meant-to-be-private diary entries chronicling her sexual degradation comprise their own chapters for all to see.

Even the doctor’s name, Louis Berger, is fairly secret. It’s used only a handful of times in the novel. Mostly, he’s called “The Doctor,” as if this nonspecific title carries with it an authority that must be obeyed if pleasure is to be delivered.

Lastly, we are presented with a climate catastrophe in the form of monster storms unlike any New York has ever seen. They impact the church building, the clinic, and everyone inside. Here, the author seems to be using the weather as an emblem of our fundamental lack of control; nature, both the environmental and sexual kind, will overrule even the best efforts of “society.” The wild winds outside the body mirror the wild forces within it.

If there’s a weakness in this otherwise outstanding novel, it’s that Loyd left me wanting to know more about the doctor, the shadowy Sarah, and all the secondary characters. That’s how well drawn they are. Nonetheless, this is a phenomenal piece of work, and I encourage you to pick it up. You’ll find it’s a real pleasure.

Chris Rutledge is a husband, father, writer, nonprofit professional, and community member living in Silver Spring, MD. Besides the Independent, his work has appeared in Kirkus Reviews, American Book Review, and countless intemperate Facebook posts, which will surely get him into trouble one day.

comments powered by Disqus