The story concerns Pierre Pain, a hypnotist and alternative doctor, who has been called in to treat the Peruvian poet César Vallejo who is dying of hiccups.
For most of the story Pain has no idea who Vallejo is, merely that he is South American and that his wife is close friend of a Madame Reynaud, who he is in love with.
The fact that Madame Reynaud called on him despite the fact that he was unable to save her husband's life six months earlier gives Pain hope that he might win her affections.
He is a lonely and introspective person but the world that he is drawn into by agreeing to treat Vallejo soon leaves him confused and alienated.
Bolaño is superb at portraying Pain's growing sense of paranoia as it seems that everyone he encounters knows exactly what is going on while he struggles to understand.
The streets of Paris in 1938, where the novel is set, are claustrophobic as Pain is followed by two Spaniards and told to stay away from Vallejo. The hospital where the poet is being treated is labyrinthine and Kafkaesque. Pain is shunned by the medical establishment and eventually evicted by a receptionist.
There are constant hints that something dark and sinister is going, for example when Madame Reynaud unexpectedly and without explanation leaves Paris for Lille, but while Pain seems to be constantly plagued with a sense of uneasiness he remains baffled as to exactly why and how he should react.
The longest scene in the novel takes place in a cinema where Pain narrates that what is happening on screen as well as what is happening to him, gradually the plot of the movie and the plot of the novel begin to intersect as Pain recognises one of the minor characters as former colleague.
Another former student, Plomeur-Boudou, who studied with Pain and the character in the movie is also in the cinema sitting beside one of the Spaniards who had been following Pain.
Plomeur-Boudou confesses that he is working for the Fascists in Spain and using his mesmeric skills to torture anti-Franco Republicans.
Patterns unfold in this novel, scenes or vignettes that seem to echo through later pages and fold back on themselves.
Monsieur Pain is a stylish tale that is effortless to read, yet richly layered, and left me feeling once again in awe of the late Chilean author.