Rating: 
Summary: Vachss at his Best
Review: This is Andrew Vacchs at his best and Burke at his most resourceful. There is a runaway girl to track down, two beautiful women to mess around with and a "grand cause" to showcase. All of this takes place in Portland, Oregon, and Burke must operate sans his extended New York family.Fans of Vachss & Burke will enjoy this book greatly for the action and the dialogue even though the plot is somewhat obscure and the climax is more than a little confusing. Also, Portland has to go- Burke belongs in New York.
Rating:
Summary: Master of His Craft
Review: Vachss has produced yet another insightful, enlightening work with his new Burke-series novel, Pain Management. The by-now infamous anti-hero/protagonist, Burke, greets this new book with yet another issue that will resonate with many readers on multiple levels--the concept that the war on drugs so beloved and embraced by the medical establishment and government alike, in actuality denies those suffering at the hands of interminably painful *terminal* illness without benefit of copious and much-needed old and newly experimental drugs due to the nonsensical idea that taking these drugs with abandon will only result in drug addiction. . . a strange proposition considering that individuals in this situation are more than likely going to face their makers any day now in any case. . .Vachss is known for writing with not only amazing knowledge and breadth of information, but entertaining while doing so, with dark humor, minimalist-style clipped sentences, that leave the reader alive with the prospect of what will come down the pike at the turn of the next page. . . although his subject matter is all inclusive of issues that are perhaps too directly hard-hitting for those not wanting to venture into the mean world of child sexual abuse, domestic violence, . . well, abuse of *any* kind, and would rather limit their diets to evening news snippets and mild conversations and move on to the rest of their lives, most readers and fans of Vachss' prose realize the import of these books. . .not only as a source of reading pleasure but, more importantly, an invaluable resource for enlisting those in the world population against the war on abuse, for children in particular, and anyone who is deemed defenseless. . . in this case, Pain Management scores highly, as do all of Vachss' preceding works of fiction. For the novice to Vachss' books, both his urban style and sophisticated level of humor might intimidate, but will surely bring the reader back for more. . And, for those inveterate Vachss' fans who await Burke's return to NYC, there is more than an intimation in Pain Management that that is precisely where his next book will take place, hopefully with his usual familial cohorts, and the always hard-edged streets of New York to keep the reader off-balance and panting in the race against whatever new villain(s) Vachss' conjures. The mere fact that the Burke series has endured for such lengthy period is nothing less than grand testament to its ineradicable nature to impart readers with more than just another book of crime fiction--it can anger, all the while displaying astonishing poignancy. . This book is yet another example of Vachss' uncanny ability to rope the reader in with headline-glowing issues, while maintaining unique intrigue and interest in characters and story alike.
Rating: 
Summary: Pain managment
Review: Vachss hasn't written a really good Burke novel since Down in the Zero. He has so much personally invested in child abuse that now he preaches in his novels rather than let his characters do the talking through their actions. Burke has become a character who threatens action rather than the gritty, down-in-the jungle darkman of the early novels. Vachss has created a great set of chartacters in Burke and his family. But this is another mediocre effort.
Rating: 
Summary: Back to the past
Review: Vachss hasn't written a really good Burke novel since Down in the Zero. He has so much personally invested in child abuse that now he preaches in his novels rather than let his characters do the talking through their actions. Burke has become a character who threatens action rather than the gritty, down-in-the jungle darkman of the early novels. Vachss has created a great set of chartacters in Burke and his family. But this is another mediocre effort.
Rating: 
Summary: Gritty Reality
Review: Vachss is my favorite writer. He always has a way to use Burke to reflect the parts of society that people don't know about or issues that we should be aware of while he keeps us entertained with his minimalist crime fiction page turners. You don't want to put one of his books down once they have you looked. This time, the issue is chronic pain managment for people with terminal illness. That is just one of the plots as Burke is searching for a missing teenager who doesn't want to be found, and fiction crosses path with reality as Burke meets a real life comic book artist suffering from Dissociative Identity disorder (or also known as multiple personality)and uses her life for a comic book. Vachss has a clever way of getting reality to seep into his fiction and when the book is done, you wonder what will happen to Burke next when he is back in New York City with the only family he knows. vachss is brutal in his fiction and it is only for the ones who want to learn about the corners of society we know little about and for those who like their crime novels gritty.
Rating:
Summary: Gritty Reality
Review: Vachss is my favorite writer. He always has a way to use Burke to reflect the parts of society that people don't know about or issues that we should be aware of while he keeps us entertained with his minimalist crime fiction page turners. You don't want to put one of his books down once they have you looked. This time, the issue is chronic pain managment for people with terminal illness. That is just one of the plots as Burke is searching for a missing teenager who doesn't want to be found, and fiction crosses path with reality as Burke meets a real life comic book artist suffering from Dissociative Identity disorder (or also known as multiple personality)and uses her life for a comic book. Vachss has a clever way of getting reality to seep into his fiction and when the book is done, you wonder what will happen to Burke next when he is back in New York City with the only family he knows. vachss is brutal in his fiction and it is only for the ones who want to learn about the corners of society we know little about and for those who like their crime novels gritty.
Rating:
Summary: Burke is the Best!
Review: What a great book ... Vachss has done a masterful job of spinning an intricate web of betrayal, lies and pain. Burke is back hunting on the mean streets of Portland ... and he's determined to find the missing Rosebud, a young girl running from an unknown pain. The trail leads Burke to some very different and unique outlaws. Every one could spell Burke's doom. And it's not just the enemies, perhaps it will be Gem, the woman who says she's Burke's wife, who will bring him down? But you're going to have to read the book to unravel this web. A fantastic read for everyone!
Rating:
Summary: Vachss Rocks Again!!
Review: 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.
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