Dr. Mate, who for twelve years practiced medicine in Vancouvers notorious Downtown Eastside North Americas most concentrated area of drug use, begins by telling the stories of his patients, who, in their destitution and uniformly tragic histories, represent one extreme of the addictive spectrum. With his trademark compassion and unflinching narrative eye, he brings to life their ill-fated and mostly misunderstood struggle for relief or escape, through substance use, from the pain that has tormented them since childhood. He also shows how the behavioural addictions of societys more fortunate members including himself differ only in degree of severity from the drug habits of his Downtown Eastside patients, and how in reality there is only one addiction process, its core objective being the self-soothing of deep-seated fears and discomforts.