What had seemed a quaint old farmhouse in northwestern Washington state when they bought it as vacation property does not feel so great when financial catastrophe forces Claire Boehning to move into it. She puts on a good face for her teenaged daughter Jory, but a series of shocks that started with a denied credit card has deeply shaken Claire’s faith in her husband Addison and in their relationship. After a difficult pregnancy and Addison’s runaway success in the pharmaceutical world, Claire has grown used to the pampered world of the fabulously wealthy, with jewelry and a waterfront home and all the toe-shoes her dancing daughter could ever want. Now, nearly broke in a rural area, Claire regrets not having obtained board certification, but finally finds a position as a second doctor in the local clinic, run on a shoestring by the aging Dan Zelaya.

The novel unfolds as Claire confronts her exhausting new job in a clinic that takes all comers, her frustrated and lonely daughter, and visits from her increasingly desperate husband, who is still haunting medical conventions trying to find new backers for the cancer drug he has developed. Carol Cassella shines in weaving the backstory into the everyday scenes, satisfying our curiosity about how they fell so far while grounding the story in Claire’s current predicaments. New mysteries are introduced, too, as Doctora Claire is drawn into the world of migrant farm workers, especially the Nicaraguan named Miguela, whose humble but dignified air of purpose (along with Claire’s need for someone to be home with Jory) eventually leads to Miguela moving into their already cramped farmhouse. Along the way we learn a great deal about how new drugs are developed, tested and brought to market in this country and who stands to gain --- and lose.

But the main thrust of the novel for me was about the relationships, and the primary strengths are how Cassella illustrates the emotional glue that binds us with seemingly small details. Mothers of teenaged daughters especially might relate to the way that Claire struggles to reassure and protect Jory, despite Jory’s recalcitrance and even her stealing. An emotional abyss comes shortly after a car accident on the mountain pass, when Claire is driving Jory back to Walmart to return a necklace. The two women must trudge miles down the snowy road, and Jory is whining about why “they” didn’t put any pay phones up there when there is no cell phone service.

Finally she looks at Jory, aware that her expression must be alarming to her child, knowing she should try to scrounge up some comforting optimism. All she can do is scream out the only truth she is sure of right now: “There is no ‘they,’ Jory. Get that through your head before you go any further in your life. There is no ‘they.’ Nobody is going to rescue you every time you f--- up. We are on our own out here.”

And yet, that is the good thing about the abyss --- the only place to go is up, and it is usually a wiser soul that climbs out. This is true in HEALER, and by the time it ends, we care deeply about a family that has learned some difficult lessons about the value of what they lost and what they still have.