By the end of the first paragraph of Ruth Madievsky’s debut novel, All-Night Pharmacy (Catapult, July), there’s no question you are in for a wild read. The story involves two sisters whose relationship is toxic and all-consuming, and Madievsky sets the stage with the voice of the unnamed narrator: “Spending time with my sister, Debbie, was like buying acid off a guy you met on the bus. You never knew 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 sisters share a grandmother who spins tales of pogroms in Russia and a paranoid, mentally unstable mother: “Her moods were the weather of my life,” the narrator recounts. “She had a kaleidoscope of diagnoses no two psychiatrists could agree upon.”

Bound in a dangerous codependency, the two young women hit the L.A. clubs, consuming alcohol and unidentified drugs. They also play Wealthy Patron, “a game where someone comes up with a weird, shitty thing a wealthy patron could pay to watch you do, and everyone else names a price.” When it’s the turn of “a skeletal hipster in wire-frame glasses,” he taps his fingers on the table and says, “ ‘I’ve got one. How much would the wealthy patron have to pay to watch a stranger plug one of your nostrils and jizz in the other?’ Everyone groaned.”

The relationship with her sister is a mystery to the narrator and causes her endless anguish: “How could I explain this thing between Debbie and me when I didn’t fully understand it myself? My whole life, I’d had this compulsion to watch over her. My presence didn’t stop her from doing what she wanted, but I felt the need to play witness. It was spiritual, how she magnetized me. How, where she went, dynamite followed. Being Debbie’s sister was obliterating.”

But then Debbie disappears, and Sasha, a Jewish refugee from Moldova, arrives, presenting herself as a psychic, prepared to act as the narrator’s spiritual guide.

Mina Hamedi at Janklow & Nesbit says she was looking for intergenerational trauma stories, sister stories, and complicated family stories when she was introduced to Madievsky by a friend, also a writer. Hamedi saw a first draft of All-Night Pharmacy in March 2020. “I responded to the voice,” she says. “The unnamed narrator with this toxic relationship with her sister. It’s toxic but she can’t let go, the attachment is too strong. There’s this balance of humor with darkness.” The immigrant experience in the story also appealed to Hamedi—“the connection to the past, where you’re removed but it’s in your genes.”

Hamedi advised Madievsky to expand the text, then signed her as a client in February 2021. They worked on the book together, and in April 2021, it went out to 14 editors.

Alicia Kroell at Catapult responded immediately.“I didn’t know Ruth, but I knew who she was,” Kroell says. “She was everywhere. Ruth is active on social media, and I had seen her pieces on Literary Hub. I was quickly blown away by the manuscript.”

Kroell points to the “nimble writing” and the “funny but difficult subject of family.” She knew she wanted the book. She showed it around and got quick yeses from everyone who saw it. “The story was strange and fresh,” she says. “Ruth is so good with imagery. The lines stay with you long after you close the book. There’s so much emotion—the sisters’ relationship is so noxious yet so intimate.” Kroell had a call with Madievsky and made the deal for North American rights in June 2021.

Madievsky moved to Los Angeles from Moldova as a Jewish refugee when she was two years old. Her love of writing started young. “Reading good books made me feel human, happy to be alive, all of it: fiction, nonfiction, poetry,” she tells me. “So I wanted to do it all myself.” She’s written for major newspapers and magazines and in 2016 published a book of poems, Emergency Brake. “If I like reading it, I want to write it!” she says.

Madievsky studied biology as an undergrad at USC and then graduated from USC's pharmacy school in 2017. She explains that her parents “were very supportive of my writing, but as immigrants, wanted me to have a profession.” She’s presently a clinical pharmacist at UCLA Health and says she enjoys her work. “I’m an extrovert. Writing and working as a medical professional are different aspects of my personality. I studied pharmacy and took creative writing classes, and there was this angst until I realized I could do both.”

All-Night Pharmacy started out as short stories, and Madievsky thought it would be a novel of linked stories. She tells me about sending her stories to T.C. Boyle, who would come to meet with creative writing students at USC, where she was getting a doctorate in pharmacy. “I just signed up by email to meet with him, and every semester, from 2014 to 2016, I casually sent him a new story.”

Looking for an agent, Madievsky sent out what material she had. “I thought it was a book, but it came to about 42 pages!” she laughs. An agent along the way suggested it would work better as a novel.

“I focused and revised it,” Madievsky says. “I engineered the stories, put meat on the bones. I felt lucky that Alicia responded in a few weeks and understood what I was doing. She got the trauma of generations and the ambiguity. I wanted to write the next Jesus’ Son, to write with a voice that pressed me down to my red blood cells.”

Madievsky expects that the book will appeal to readers who like complicated women, and also that some will love it and some will hate it. She did, after all, devise the “Madievsky Rule” in a 2020 Lit Hub article: “3.5 stars on Goodreads is the sweet spot for contemporary literary fiction written by women about women.”

I expect All-Night Pharmacy will hit that sweet spot.