Every time Kate Ledger walked into a bookstore, she stopped and looked around at the books surrounding her, and thought, “All of these people have written books. Why can’t I finish my novel?”

It ultimately took 10 years, but today the St. Paul writer can find her own book, “Remedies,” right up there in the L section. And after several false steps, she is certain that it’s the book she wanted to write all along.

“I had written the first chapter over and over again, I had a nearly full first draft, and it wasn’t right. I wasn’t sure what to do,” she says. “Then I met [the novelist] Pete Dexter at a writing conference, and I asked him, ‘I’ve been working on this book for years now, and how do I make the transition from first to second draft?’ And he said, ‘Oh, I don’t do second drafts.’ Well, I definitely needed to do a second draft. Then he said, “Maybe this is something you need to stick in a drawer for now. Maybe this just isn’t the right book for you, and you need to do something else right now.’ ”

Ledger considered this idea for a while, then thought, “No, no — this is definitely the right book for me to be writing right now. This is the book.”

For years, she had worked at Johns Hopkins Hospital as a medical writer, and she describes herself as a very confident writer and very conversant with the health care field. It shows in “Remedies,” a polished, complex, sure-footed page-turner that doesn’t feel like a first novel.

The idea of the book began to form in her mind years earlier, and as her work life centered around health care topics, the novel did, too. A decade ago, she left her job, moved with her husband to the Twin Cities and began writing, mostly working as a freelance journalist with an emphasis on health care topics — although she wrote the occasional story about baseball, too. But in the margins between those assignments, she kept coming back to her novel, to the charismatic and driven doctor she had created, and to the central theme of pain.

In “Remedies,” Ledger follows a couple trying to recover from the death of their child. The husband distracts himself through his work as a family physician, and becomes consumed by the discovery of a new pain management treatment. The wife finds escape through infidelity.

“I knew what I was trying to say, but I couldn’t quite find the right tone,” Ledger says. She worked up until the end, then realized in the last 20 or so pages of the book, she’d finally hit it. “And then I realized the beginning was all wrong,” she says. She needed to start over, a task that was made easier by the fact that she just happened to have misplaced the disk that the earlier parts of the novel had been stored on. She didn’t panic, as most writers would have done. She began again, and this time, it came together.

Writing about such topics as the death of a child and the corrosion of a marriage could have been difficult, admits Ledger, who became a parent during the years she was writing the book. “The scariest thing I could imagine was the death of a child. And there is the fear that when you put something down on the page, it will come back to haunt you, appear in your real life. But I was writing about pain, and I knew these people were suffering from something very important, and when that came to me, I knew it was the right story,” she says.

Ledger’s book raises questions about chronic physical pain, as well as emotional pain, dislocation and disconnection, and the ways we distract ourselves to avoid facing these issues. That’s why the new book has already become a hot discussion topic: Self magazine has selected it for its September book pick, Mommycast.com has made it an online book club topic, and the Jewish Community Center has made it the official “Community Read” of the Twin Cities Jewish Book Fair in November.

“I think there’s a lot going on beneath the surface of these characters, and through them we can think about the things we are struggling with in our society, or the things we’ve lost,” she says. “And maybe we can find a way to heal them.”