All-Night Pharmacy, Ruth Madievsky

Acid Trips Meet Ancestral Trauma in ‘All-Night Pharmacy’

With the same shocking specificity that sets apart her poetry, Ruth Madievsky’s All-Night Pharmacy brings us uncomfortably close to everything the narrator witnesses in a hospital waiting room.

All-Night Pharmacy
Ruth Madievsky
July 11, 2023

“It is redundant,” Truman Capote quips, “to die in Los Angeles.” This is certainly Debbie’s attitude. Debbie, older sister to the unnamed narrator of All-Night Pharmacy, may not be the book’s main character, but she is one of the many beating pulses at the story’s core which makes Ruth Madievsky’s novel as ensnaring as a floor-filling house track. The narrator lets readers into her neon Los Angeles world by explaining that spending time with Debbie is “like buying acid off a guy you meet on the bus. You never know if it would end with you, euphoric, tanning topless on a fishing boat headed for Ensenada, or coming to in a gas station bathroom, the insides of your eyes feeling as though they’d been scraped out with spoons. Often, it was both.”

This is the type of searing prose which lends All-Night Pharmacy the sensation that the ink itself is sizzling on the page. The biggest difference between this and other equally flashy novels full of clever-one liners and unexpected imagery is that Madievsky has the literary acumen to pull it off. A published essayist and poet, Madievsky now makes her novelistic debut with an instant addition to the LA novel canon. But more than just being about SoCal, All-Night Pharmacy is about what it means to be a product of history, which is to say, what it means to be alive.

These questions drive our unnamed narrator, who struggles tirelessly searching for a way to be. She battles codependence at every turn, be it with Debbie, the pills they’re both addicted to, or the self-proclaimed psychic acting as her spiritual guide-turned-lover. She grapples with her inability for self-determination, often losing her sense of self in the light of her relationship to others. If the narrator’s personal strife isn’t enough to juggle, she’s also balancing the generational traumas of her former-USSR immigrant family.

Often, these so-called “unhinged woman” novels, like Ottessa Moshfegh’s My Year of Rest and Relaxation or Sylvia Plath’s The Bell Jar can feel somewhat plotless. In a society where the identity of “woman” is constructed to be the pinnacle of respectability and passivity, watching the inevitable psychological unraveling of a woman struggling with such is spectacle enough. But All-Night Pharmacy couldn’t be farther from this categorization. As easy as it is to become invested in the narrator’s interiority, the stakes of the real world around her are just as arresting.

All-Night Pharmacy‘s driving conflict is Debbie’s disappearance, and the narrator’s subsequent grapplings over whether or not to look for her. Every synopsis of the book I could find, including the one printed on its dust jacket, mentions this right off the bat, so I expected it to be the story’s inciting action. In truth, Debbie doesn’t go missing until nearly a third of the way through All-Night Pharmacy, which left me feeling a bit off-balance as I kept waiting for what I knew was coming. Still, the time readers get to spend watching Debbie and the narrator together is invaluable; Madievsky paints a devastatingly complex relationship between two sisters struggling to care for each other in a world that makes no attempt to care for them. 

If All-Night Pharmacy is a sister novel, it is not solely a sister novel. After Debbie’s disappearance, our narrator takes a job as a receptionist in an emergency room where she’s able to covertly sell pills on the side to support the addiction Debbie left behind in her wake. With Debbie gone, the narrator can’t fully make peace with her decision not to look for her, or escape reckoning with what it means to relate to others.

That Madievsky works as a clinical pharmacist and that the narrator’s time at her own hospital job contains some of the novel’s most gripping prose is surely no coincidence. With the same shocking specificity that sets apart her poetry, Madievsky brings us uncomfortably close to everything the narrator witnesses in the waiting room: “recovery and death and, more often than you’d expect, something startlingly in between”; the patient “complaining of Shoah grief” who seeks solidarity from our Jewish narrator; a woman with a “thin, silvery voice [reminiscent] of a barspoon with a twisted handle” who claims to be psychic.

The latter turns out to be Sasha, one of the novel’s main characters, despite showing up on page 117 of a 281 page book. Sasha introduces herself to the narrator as her “amulet”, intent on helping her “find [the] way back” to her destined path. Madievsky’s flirtation with the authenticity of Sasha’s purported powers is a delight; another mirror in All-Night Pharmacy‘s endless acid trip fun house. The narrator’s supernatural-turned-sexual dependence on Sasha and her psychic gifts is a poignant parallel to her difficulty differentiating her identity from Debbie’s.

On another level, watching the narrator cycle through losing herself over and over again to different things – her sister, Sasha, pills – seems a reflection of the generational trauma she has to sift through with her Soviet family. Furthering the kaleidoscopic refractions, our narrator has to face her ancestor’s homeland and its ghosts when she and Sasha visit Moldova together.

[spoiler alert] Is Sasha a sham? Is the narrator justified in giving up the search for her sister? In this slightly surreal world of doubles, it seems to not matter. The narrator chooses to believe Sasha. She chooses to try to move on from Debbie …until she finally chooses to look for her. Though her turmoil and debasement along the way is great, she is ultimately offered a chance for redemption at most every turn. Madievsky seems to suggest that self-determination is the highest form of truth; that by simply making a choice and living within its confines, the narrator proves her decision was the right one.  

All-Night Pharmacy is a blazing success, and a joyous addition to a collection of Los Angeles literature as sprawling as the lights in the hills. Pulsing prose and memorable one-liners make Madievsky’s story a helpful example in the “novels-by-poets-are-superior” argument. If All-Night Pharmacy suffers from some slight issues of pacing, these are outshone by the incredible cast of fully-realized characters who are the novel’s ultimate triumph.

With all the symbolic significance of the narrator’s relationships, it might have been easy to reduce the other characters to a trope, but instead, everyone in the narrator’s world flashes with the immediacy and intensity of a club’s strobe light. Madievsky is no stranger to a truth that comes into sharp relief in emergency waiting rooms: no matter how bizarre your story, the person next to you has a tale that could set your head spinning.

RATING 8 / 10