The most used word in Roxana Robinson's brilliant and devastating novel Cost is "unbearable" and its variants. The word sums up perfectly the emotions, choices and horrible ironies that buffet a patrician, buttoned-up family whose youngest son is a heroin addict.

This tragedy comes on the heels of a more usual one. Julia Treadwell Lambert's parents, who are guests in her Maine summer home, are elderly and fading. The book begins with her ever cheerful mother, Katharine, realizing with her Zen equanimity that she's losing her memory. Julia's father Edward isn't losing his memory, but his body is betraying him. Into the mix comes Julia's older, responsible son Steve, back from a failure to save the trees in the Northwest; her brittle sister Harriet; and Julia's ex-husband Wendell, angry and uncomprehending at what's happening to his younger son Jack.

Jack is largely the reason for all the "unbearables" scattered throughout the narrative. Talented and funny when he's in his right mind, he's intelligent enough to compare himself to a desert prophet as he joneses for heroin, but he can't stay off the path to self-destruction. The family interventions led by Ralph Carpenter, head of a rehab program, are excruciating, and absurd. The stiff-necked and hypercritical Edward was a neurosurgeon, but all his knowledge of the human brain can't help his grandson, whose own brain has been hijacked by one of the most insidious drugs known. Sweet, smiling Katharine hardly knows who Jack is anymore; Harriet hardly knew who he was in the first place. Steve, who dedicated their childhood to getting his brother out of scrapes, is helpless. Jack's predicament dredges up the old bitterness between his parents, even as it draws them closer.

A reader searching for a nice book about a bucolic summer in a gently rundown beach house won't find it here. Robinson's descriptions of Jack's physical pain and discomfort, insane cravings and general madness are some of the most harrowing passages this reviewer has ever read. Cost is a perfect title for this wrenching book; everything this family does seems to extract a price that's too high to pay.

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