Kate, who has been put away for years in a hospital for the criminally insane, is out now and living by the railroad tracks in a furnished room. Phoebe, ostensibly Nancy's mother, is running scared and putting out contracts with an Albany hit man. The Mayor of this same small upstate New York town is found dead in his office with knitting needles stabbed into his eyes. Lester Mather, community stalwart, is stabbed in the heart. A minor gangster named Nickie is found shot in the head by the river. Nancy's father kills himself. The local psychiatrist is found in his garage with his neck cut through by a pair of shears. At times tender and abysmal, always engaging in energetic jumps from scene to scene, its many characters, their secrets, obsessions, and rich moments of eloquent madness makes Pale Horse a fierce event, perhaps where Dostoyevsky and True Detective meet and wrestle each other in the dark of night.