Structure

Empire of Pain is divided into three sprawling books, the first book of which (Book I Patriarch) details the early life and success of Arthur Sackler. Keefe documents every side hustle that Arthur had in high school, and there were many, including a surprising number of jobs in marketing and advertising. Keefe spends lavish amounts of time in Book I telling Arthur's early childhood story because the poverty he and has family experienced served as a catalyst for young Arthur's overwhelming ambition. Isaac Sackler, Arthur's father, could not provide well for his family, and the three Sackler brothers had to try to make up for this failing. Arthur, Mortimer, and Raymond Sackler would spend the rest of their lives highlighting the family's good name and erasing the earlier financial struggles.

Book I also explains the origin of the first family fortune. Arthur markets "Penicillin for the Blues...