Mini-Review: Patrick Radden Keefe’s EMPIRE OF PAIN

Empire_of_PainPatrick Radden Keefe’s Empire of Pain: The Secret History of the Sackler Dynasty (2021) is as remarkable, precise, well-written, measured, and ethical a book as Radden Keefe’s Say Nothing, my 2021 book of the year. And Empire of Pain may take it for 2023. It’s early days yet, but it’s not likely I’ll forget it.

What I appreciate the most about Radden Keefe is his ability to balance impeccably sourced and researched content AND a tone of banked righteous anger, a moral core, a sense of things not right. Radden Keefe, through careful, thorough research, interviews, and clear, penetrating prose brings the sins of the Sacklers to life in the lives of the people most hurt by their dishonest business practices in selling Oxycontin and bringing us to the opioid crisis as we know it today.

While Radden Keefe makes the victims, the injured construction worker, the car accident victim, the centre of what the Sacklers have wrought, he also, as I said in my GR note, tells the tale of a Karamazovian family of the pharmaceutical industry, blind to their guilt, their wrongdoing, their cavalier exploitation of the vulnerable that it nears tragic proportions of hubris unmitigated by enlightenment, by one moment of remorse or regret. The Sacklers don’t have an Alyosha… 

I’ll indulge in two passages of utter perfection: one marries America’s two scourges, opioids and guns and the other alludes to one of my favourite novels and whose quotation, one of my favourites of any novel, gets to the heart of the matter (in Radden Keefe’s concluding “A Note on the Sources”):

In some ways, Richard’s [Sackler’s] argument about Oxycontin mirrored the libertarian position of a firearms manufacturer who insists that he bears no responsibility for gun deaths. Guns don’t kill people; people kill people. It is a peculiar hallmark of the American economy that you can produce a dangerous product and effectively off-load any legal liability for whatever destruction that product may cause by pointing to the individual responsibility of the consumer. “Abusers aren’t victims,” Richard said. “They are the victimizers.” (230)

One evening as I was in the later stages of writing this book, I received an envelope in my mailbox at home. It had no return address, just a thumb drive and a slip of paper with a quotation from The Great Gatsby: “They were careless people…they smashed up things and creatures and then retreated back into their money or their vast carelessness or whatever it was that kept them together, and let other people clean up the mess.” The thumb drive contained thousands of pages of depositions, law enforcement files, and internal records that had been produced in a number of lawsuits against Purdue. (451)

If you read one non-fiction book this year, or if you read many, make it, or one of them, Radden Keefe’s Empire of Pain. And if you haven’t read Say Nothing, read that too. (I found it particularly fascinating and telling how Radden Keefe writes about “careless,” morally expedient people: the Sacklers in one book, with their blind hubris and the wily, gas-lighting Gerry Adams in the other: his portrayals of these figures alone are worth reading about.)

17 thoughts on “Mini-Review: Patrick Radden Keefe’s EMPIRE OF PAIN

  1. Another excellent review. I agree on all counts. You capably spell out why Keefe’s books about tragic situations continue to impress.


    1. Much welcome!! BTW, I received the book, thank you very much…should have emailed you, but I’m on the last lags of the work week before I go on March break. Can’t wait to read it!!

      Liked by 1 person

  2. This made my Best Of list for 2021 – it’s remarkable.

    I read a bunch of press after the book and shock of shocks, the Sacklers were apparently unthrilled, but if anything I thought Radden Keefe was shockingly even-handed. As you say – it’s a banked righteous anger which I think makes for a more powerful read. I, myself, swung from barely suppressed rage to marveling at the amazing capacity for hubris displayed by the family. It didn’t rivet me on the same level as Say Nothing did, but hell, that’s splitting hairs.


    1. Same here, it might be, like Say Nothing was, my book of the year!

      I too felt that, rage, and sometimes I was in tears. What I didn’t mention and should’ve is Radden Keefe’s ability to bring all the pathos with such subtlety: those families holding up the pictures of their loved ones. And the Sacklers so unmoved, so sure they can blame the victims (that’s why I loved his analogy with the gun industry).

      He was, you put it perfectly, “even-handed”, measured, which, of course, Sackler unthrilldom evidence, makes his claim and perspective even more convincing. I just don’t know how he does it! (I have this secret dread that this will be too much to keep up and he won’t write another book! #readeranxiety, it’s a thing.)


  3. Great review. ‘Say Nothing’ is one of my favourite books of recent years – as someone from the north of Ireland, his understanding and research astounded me. I’m always in awe of how he maintains the balance in his books, he did the same in ‘Rogues’ with some difficult characters and I’m already looking forward to ‘The snakehead’. I’ll be bereft when I have read all of his books!


    1. Thank you, so kind of you to say so!

      I agree. I think Radden Keefe’s writing is phenomenal: it’s difficult to infuse journalistic writing with literary depth.

      I hear you re: Northern Ireland. As someone whose father and uncles fought in the Greek Civil War (on both sides, there were six boys), any account of civil strife is meaningful, painful, but compelling. And I remember when Bobby Sands died…there’s a perfect little reference to the event in Claire Keegan’s “Foster”, another great narrative I read this year.

      I have Rogues in the summer TBR and am looking forward to it. “Bereft” is how good writers should leave us, of any genre. Coetzee has a new book coming out, as does Michael Cunningham, a few to look forward to. And the Edgar winner, for best novel, was awesome.


      1. I’d say you’ve heard some interesting stories from the civil war in Greece? I was only eight when Bobby Sands died, but I can remember it and the aftermath clearly. As I get older, more memories of those times surface. I agree with you about ‘Foster’, superb, small and perfectly formed. ‘An Cailín ciúin’ the resulting movie is pretty close to perfect too.

        I agree, but bereft isn’t something I feel too often these days. Maybe I’m not reading the right books or just not as involved as I used to be. Age, maybe. It takes a lot more for a book to stand out with me. I’ve been enjoying the world created Emily St. John mandel recently, I was sad to finish her books.

        I haven’t read Coetzee, would you make a recommendation about where to start? Edgar winner as in ‘Notes on an execution’? Weeks on and I still can’t get that book out of my head. That book made me think more than any other I’ve read this year. Don’t believe I’ve read Michael Cunningham so that’s another one to check out, thanks!


        1. Endless stories about my father and his brothers in the Resistance and, later, the Civil War…it was the background to my childhood.

          Yes, I was older and remember being agog at the news of Bobby Sands. It marked that time. And reading Say Nothing brought it back. What a truly remarkable telling Radden Keefe did, bringing so many threads together, that opening in Boston, the story of Doulours, but most haunting and revealing, the presence of Gerry Adams. Did you hear the interview he did with the two dudes who do the Rest Is Politics podcast?

          I still love to read, but I can’t abide most contemporary fiction: it never quite lives up to its promise, often strikes me as thematically void, and rather than bereft, I’m relieved it’s over when I turn the last page. That’s why it was great to read “Foster”. Didn’t know there was a film?!!

          Coetzee is great, difficult and challenging, but clear, succinct, thematically rich. I would start with DISGRACE. I think, painful as its events are, it’s the most accessible way into his work. I also thought AGE OF IRON was terrific. After that, if you’re still keen, WAITING FOR THE BARBARIANS (do read Cavafy’s poem of the same title, it inspired Coetzee and is terrific) and maybe also The Life and Times of Michael K.

          Hmmm, I haven’t read Notes On an Execution, but I will, thank you! Just saw the ’23 winners were announced. I read the 2022 winner, FIVE DECEMBERS and it was wow.


          1. I haven’t heard that podcast, but I have just downloaded it. And thanks for the Coetzee recommendation, I’ll start there. And five decembers looks like it could be the sort of book I might just love. Great to get recommendations.

            The film was nominated for an Oscar as ‘The quiet girl’ or ‘An cailín ciúin’ as gaeilge. It’s loosely based on the book and I think it really captures the essence of it. Both the ending of the book and the film are incredibly moving.


            1. I’m a podcast “addict”, which, as far as “addictions” go, is pretty harmless. My two faves are The Rest Is History and Empire, terrific and, because of the hosts’ exchanges, guffaw-worthy funny.

              That ending: it’s with me still. And I can watch the film on Amazon Canada, excellent.


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