Dr. Malcolm Avery has spent years learning how to sit with other people's pain.
A former Catholic priest and now a respected psychologist, Malcolm leads an interpersonal therapy group in Baltimore where six adults arrive carrying very different versions of themselves-and very different ideas about what it means to heal.
Nia Whitaker is caring for a dying mother she cannot save. Daniel Mercer is struggling to protect the Black father who raised him without destroying what remains of his marriage. Marcus Reed is confronting a childhood violation he was taught not to recognize as abuse. Everett Shaw watches everyone with the practiced suspicion of a man who notices what others would rather leave unsaid. And Leni Vargas, funny, capable, frequently five minutes late, seems to understand better than most how much of life happens outside the room.
Then Leni dies.
In the aftermath, grief becomes investigation. Every conversation is remembered differently. Every clinical judgment looks different in retrospect. Malcolm, his closest colleague, and the institution overseeing their work must confront a question with no comfortable answer: when a reasonable decision ends in tragedy, does the outcome prove the decision was wrong?
For Malcolm, the question becomes more dangerous when he discovers that Everett did not enter his group by accident. He came looking for Malcolm-and for the truth about a decision Malcolm made years ago, when he was still a priest.
PAIN IN MY ECOSYSTEM is a literary psychological novel about grief, responsibility, therapy, faith, race, family, institutional power, and the limits of knowing another human being. It asks what happens when intelligent, morally serious people make defensible choices-and those choices still hurt the people they hoped to help.
