The title of Darin Strauss' third novel, More Than It Hurts You, evokes torture scenes from old mobster movies. "This hurts me..." spoken with the utmost sincerity right before a smooth-talking goon starts working over some shlub with a pair of pliers. This crackerjack novel works you over just as thoroughly. Strauss (author of Chang and Eng and The Real McCoy) knows how to get under your skin—cleverly constructing a story that burns and festers, leaving you slightly traumatized and utterly invested in the moment.

The novel opens with Josh Goldin, a good-looking network salesman who's ripped from the calm of his mundane workday when his wife, Dori, calls to say that their baby is in the hospital—vomiting blood. What follows is a family crisis that eventually pits Dr. Darlene Stokes, a black single mother who's worked excruciatingly hard all her life to become the head of the pediatric department, against the successful young Jewish couple. Dr. Stokes believes Dori suffers from the controversial Munchausen by proxy syndrome, in which a parent hurts their child in order to get attention for themself. As Josh, Dori, and Dr. Stokes' lives get further entangled in the media blitz of a black doctor trying to take away a white couple's baby, it becomes evident that Strauss has written a satire filled with repugnant yet utterly sympathetic characters.

Blood sacrifice becomes the central theme in the novel's forward motion. What would you do in order to ensure your future happiness? "Maybe that's what happiness always required—and the people who had happy lives were those who were most comfortable with that arrangement. You had to be willing to take a little blood from people to make yourself happy, and that was that." When it comes time for Josh to confront this fallacy, Strauss' novel hits an unparalleled stride, hurtling the reader ever deeper into a dark place where things aren't as they should be.

More Than It Hurts You is a riveting novel, filled with broken dreams, social commentary, and the tangled skein of intimate relationships and internal monologues. It takes place in a world where people hurt the ones they're supposed to love the most. The truly unnerving part: It's a world much like our own.