Pain Killers: A Year in the ER

I no sooner posted that I wouldn't be doing much reading this month when I received a message from Book Sirens about a review for the above book coming due. So I read it last night. Last year I read author Rachel Callaghan's Under Water. It was my second best book for 2024, behind a graphic novel, so it was technically my best fiction novel. Callaghan is a former ER physician. The story is in the epistolary form where the plot is revealed through physicians’ notes, ER logbook entries, and letters between the characters. It was published on July 25, 2025.

The publisher's summary:  

The year is 1978. Mary Grace Kelly flees to a new city with a set of scrubs, a nursing license, and a secret. She hopes to hide in this bustling blur of cranky patients and even crankier physicians. Complaining to her sister back home, Mary Grace’s letters describe her arrogant, infuriating colleague Dr. David Korn, who wears his sarcasm like another white coat. But when her therapy sessions land her in a waiting room with this man, her irritation turns into intrigue. Their reluctant bond deepens until her father’s illness yanks Mary Grace back into her unresolved trauma.

David’s sexual frustrations leak out with wry, Jewish humor in notes to his brother. His sibling is quick to point to David’s past relationship failures as evidence that he’s a “self-indulgent bastard.” For all his bluster, David wants something more meaningful but knows his family will never approve of his relationship with Catholic Mary Grace. She’s challenging all his preconceived notions, but does he have the patience to wait for her to find the healing she needs?

A vaudevillian uncle, a retired nun, and an elderly vagrant conspire to help Mary Grace find her way. But she must first learn to trust again.

The fast-paced, epistolary style of Pain Killers allows the reader to eavesdrop on the controlled chaos in emergency care. Before desktop computers, the relentless rhythm of the ER was documented through a heap of administrative paperwork. Callaghan skillfully weaves a story from this patchwork, revealing the humanity behind the charts and clipboards in short snatches dripping with subtext. Like the emergency room it chronicles, Pain Killers taps the vein between protocol and improv.

Rx for busy readers on the go

Prescribe this book to readers jonesing for the insider grit of medical fiction compounded with the warmth of a romantic dramedy microdosed in snippets. Severe to moderate distraction may occur: failing to notice you’ve been called to dinner, you’ve missed your subway stop, or your professor has asked what you’re reading. Take as needed to alleviate symptoms of boredom, existential nausea, or the yearning for human connection.

The story was cute. I enjoyed the epistolary form, especially the doctor and nurse notes on patients.  I know that the notes are true to life because I worked in a hospital way back in the 1970s. The book isn't a mystery as I expected it would be but rather general fiction. It was a nice break from my usual fare but I have to admit that there wasn't much suspense. Even so, I read it in one sitting. Pain Killers was a relaxing way to spend an evening. Mary Grace is the main character. She had something awful happen to her when she was a teen but it wasn't revealed until the middle of the novel. For the remainder of the story she tried dealing with her emotions, somewhat successfully. I noticed that Mary Grace was constantly writing her sister letters but that sister Kathleen never responded. Clue number one. Dr. David Korn annoys her so she tries avoiding him. As I expected, they eventually began dating. Clue number two. They are very different people but their relationship seems to work. Mary Grace is a strong Roman Catholic while Dave is a non-practicing Jew. 

Pain Killers: A Year in the ER is a sweet, uncomplicated story. I am rating it 4 out of 5 stars.