Set in Frank's café, a greasy spoon diner in New York City's Upper Broadway neighborhood, Balm in Gilead loosely centers on Joe, a cynical drug dealer, and Darlene, a naïve new arrival to the big city, over the course of three days. Joe and Darlene spend the night together hours after meeting, but he soon pushes her away, overwhelmed by his debt to a local kingpin named Chuckles. Darlene, meanwhile, finds herself ill-equipped to handle life in a New York slum, and she becomes increasingly vulnerable to the attentions of the various low-rent men who hang around the café looking for an easy target.