Wilson's first full-length effort, Balm in Gilead centers on a cafe frequented by heroin addicts, prostitutes (both male and female) and thieves. It features many unconventional theatrical devices, such as overlapping dialogue, simultaneous scenes and largely unsympathetic lead characters. The plot draws a parallel between the amoral, often criminal activity that the café's denizens engage in to provide temporary relief from their boredom and suffering, and the two main characters' becoming a couple in order to escape from their lives.
The play takes its title from a quote in the Old Testament. (Book of Jeremiah, chapter 46, v. 11)
Wilson wrote the play while living in New York City, finding inspiration by sitting in cafés and listening to different conversations. He approached Marshall W. Mason, whom he knew from the Caffe Cino, to direct the production. After workshops in the directing and playwriting units of the Actors Studio, it debuted off-off-Broadway at the La Mama Experimental Theater Club on January 20, 1965, and was a notable critical and commercial success. It was the first full-length play produced off-off-Broadway. Wilson said that he wrote the play partially because he wanted "to break out of the physical limitations inherent in wrting a play for the Cino." (referring to the Caffee Cino). and became the first play from off-off-Broadway to be published (by Hill and Wang).
The Steppenwolf Theatre Company production ran from September 18, 1980 to October 16. It was directed by John Malkovich.
A production co-produced by the Circle Repertory Company and Steppenwolf Theatre Company ran Off-Broadway from May 31, 1984 to January 6, 1985 at the Circle Repertory Theatre. Directed by John Malkovich, the 1984 cast featured Jonathan Hogan, Danton Stone, Laurie Metcalf, Gary Sinise, Giancarlo Esposito, and Glenne Headly. Metcalf was praised for her performance, specifically for her 20-minute monologue in Act Two.
In 2005 the play was revived by the Barefoot Theatre Company at the Sargeant Theater (New York City), under the direction of Eric Nightengale, who assisted Malkovich in the 1984 revival. The Barefoot revival starred Anna Chlumsky and Francisco Solorzano, and featured Victoria Malvagno, Luca Pierruci, Jennie West, John Gazzale, Trey Gibbons, Jeff Keilholtz, and Diego Kelman Ajuz.
In 2010, the play returned to its off-off Broadway roots in a revival by the company at T. Schreiber Studio in New York City. The revival, under the direction of the studio's associate artistic director, Peter Jensen, experienced widespread critical and audience acclaim, including recognition from Backstage Magazine for the ensemble as one of their favorite performances of 2010-2011. The overwhelming response throughout the off-off-Broadway community resulted in two extensions of the initial six-week run, ending after nine weeks on December 18, 2010. The revival played to sold-out houses for every show throughout the entire run, including playwright Lanford Wilson himself on December 12, 2010, who summed up his thoughts on the production by calling it "a thrill to see". This would be the final production of his own work that he would see before his death in March 2011.
In September 2011, this production garnered six New York Innovative Theatre Awards nominations for off-off Broadway productions, including for Actress in a Lead Role (Jill Bianchini and Belle Caplis), Ensemble, Costume Design (Anne Wingate), Sound Design (Andy Cohen) and won the award for Outstanding Production of a Play.
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.
Joe sees in Darlene a chance for a fresh start, and briefly considers giving up dealing. Just as he is about to return Chuckles' money, however, he is killed by one of the dealer's thugs. The play ends with all the principal characters droning their lines from the first scene over and over again in a circle, implying that their lives are stuck in a demoralizing rut.Joe, a small-time drug dealer looking to go into business with Chuckles, the local kingpin
Darlene, a naïve young woman newly arrived to New York
Dopey, an older junkie
Fick, a pathetic, childlike junkie
Ann, a prostitute
John, the café's manager
Frank, a fry cook at the cafe
Kay, a waitress at the cafe
Franny, a transvestite prostitute who caters to many of the café's other hustlers
Tig and Bob, two sociopathic junkies and hustlers who prey on attractive new arrivals (both male and female) to the café
Xavier, Joe's friend and fellow drug dealer, whose exploitation of a particularly wretched junkie moves Joe to consider quitting.
Rake, a hustler, one of the "Fellows on the Corner".
Bonnie, a prostitute
Stranger, Chuckles' hitman
Ernesto, a hustler
Rust, a prostitute
Babe, a really "far gone" junkie
Al, an alcoholic bum
Martin, a junkie
David, a hussler
Terry, and Judy, two prostitutes
Carlo, a hustler
Tim, a hustler
The 1984 Off-Broadway revival won
1985 Drama Desk Award
Outstanding Ensemble Acting
Outstanding Director of a Play, John Malkovich
1985 Outer Critics Circle Award, Best Director, John Malkovich
1985 Obie Award
Performance, Laurie Metcalf
Direction, John Malkovich