Super interesting concept of a mystery (sort of?) taking place within a hospital setting. I loved following a character trying to solve a problem while deteriorating throughout the story. I felt like it started with interesting commentary on the medical industrial complex that I wish would've carried through a bit more. On a writing note, I did not love that many of the initial chapters ended with some variation of "If I had known then..." and let things reveal more naturally.

Thanks to NetGalley and St. Martin's Press for providing an eGalley in exchange for an honest review.

3.5 stars, rounded down!

The Graceview Patient started off as a suspenseful thriller that kept me on the edge of my seat. As a nurse, the medical scenes and terminology was surprisingly accurate....and then it started to become far fetched and the story went in a different direction out of nowhere, taking on a more traditional horror arc. I felt that there were a lot of loose ends that never really were tied up or even remotely explained by the end.

The Graceview Patient would be best for fans of horror with a traditional thriller element thrown in; I'm not sure that traditional thriller readers will love this as much. All in all though, a quick suspenseful read!

Margaret joins an exclusive clinical trial to treat her rare autoimmune condition - while the cure sounds promising, the treatment involves destroying her immune system in order to build it back again. This book chronicles her hospital stay through the course of her treatment.

This thriller combines psychological elements (what is real and what is not as Margaret gets more disoriented as the drugs flow?) as well as body horror as a result of the clinical trial. The hospital becomes a character in and of itself, and Margaret must attempt to understand what she's actually enduring in order to survive. The body horror elements were chilling and gross in the best way, and the narrator made unreliable by medications kept me guessing throughout the novel. I still don't know for sure what was real! Readers who enjoy books like Nick Cutter's "The Troop" will relish in the scenes from this book.

The author did a good job incorporating real medical elements - I could tell she did her research and/or has a history in the medical field, as the hospital setting and descriptions of nursing roles and treatment were more accurate than most books.

Thank you to NetGalley and St. Martin's Press for providing a copy of this e-ARC in exchange for my honest review.

Thank You St. Martin's Press for a ARC copy of this book. I truly do appreciate it a lot. Also thank you Netgalley.

Margaret has a rare autoimmune condition, that has destroyed her life, leaving her isolated from everything. It has no cure, but she has been doing the best she can. That is until she is offered a fully paid spot in a experimental medical trial at Graceview Memorial. The conditions are grueling, she will live at the hospital as full time patient, subjecting herself to near destruction of her immune system and regeneration. The trial will kill most of it, but not all of her. As the treatment starts to progress her body begins to fail her, she also stumbles on something sinister living within the walls of the hospital.

She is unsure what is real, and what is a medication induced delusion. Margaret is struggling to find a way out of her body and mind succumb further into the darkness lurking throughout the Graceview halls.

I do like horror, it is not my favourite genre because sometimes it can be scary or really gross.

I was so so excited to read this book, and in the beginning I was so invested into the story and the plot. After awhile though I just got kind of bored and not that interested. Also the main character was just so whiny every single chapter she was crying or whining about something that happened. This book starts off strong but then near the middle/ end I just lost interest in it. Also at some points in the story the plot was a little confusing. The pacing was somewhat good, but then it got a bit slow after.I was just so invested in this book. This was my first book by this author, and maybe in the future I will read another book by her, but as of right now I have to many books on my TBR to read. It was a book moving at a snail's pace with a very unsatisfying ending.

Happy Reading!!!!!

𝗥𝗔𝗧𝗜𝗡𝗚: ★ ★ ★ ★
𝗔𝗥𝗖 𝗥𝗘𝗩𝗜𝗘𝗪:

This was my first read by Caitlin Starling and I am hooked on their writing. The twists and turns and how she makes you FEEL the feelings in the book. The way my brain had to sit at the very end and process everything I read. You go through wild and crazy twists, so much tension and palm sweating suspense, you’ll be questions reality just like our FMC the entire time. The setting in an eerie hospital and the things that HAPPEN in this hospital will leave you with that deep sick pit in your stomach and the lump in your throat until the very end. Just as stated in the synopsis, if you loved Misery and Body Snatchers then this is 100% up your lane and you need to put this on your TBR right away

𝗧𝗥𝗢𝗣𝗘𝗦: Dark, Twisty, Eerie, Creepy, Mind Bending, Fast Paced, Dark Hospital, High Tension, Palm Sweating Suspense

Large thank you to our Author, NetGalley as well as St. Martin's Press

I finished this one a week or so ago and am still not sure how I feel about it. On the one hand, Starling is such a good writer, and I've loved all of her other work. She could make even the most mundane task unsettling. On the other hand, I found the last third of this book really confusing, and I'm still not sure what happened and to whom? Why were there doubles of some people? I don't get it, even after re-reading some parts. I dunno, dude. This one might need a bit more fine-tuning before the publication date.

I love all of Caitlin sterling’s works, and this was no different. I appreciate how she crafts relatable characters and places them in environments that (hopefully) we would never find ourselves. A little mix of possible supernatural with human nature created a relevant and captivating story!

An Intriguing Premise, Murky Execution
The Graceview Patient by Caitlin Starling sets up an eerie, atmospheric mystery that pulls you in with its haunting setting and unsettling tension. However, much like its main character, the narrative often feels adrift. The protagonist’s motivations and development lack clarity, making it difficult to connect with her journey or understand her choices. Compounding that, the story raises many fascinating questions—about identity, memory, and the nature of reality—but leaves too many threads unresolved or vaguely addressed. The result is a novel that feels more like a fever dream than a tightly-wound psychological thriller. Still, Starling’s signature sense of dread and slow-burning suspense make it worth the read, even if the final destination doesn’t quite satisfy.

I really enjoyed this medical horror, even if it's outside the genre I would typically pick up. The only thing that takes it down a star rating writing-wise is that the ending is almost thrown in so last minute that it doesn't seem to fit with the rest of the plot. I am okay with it being ambiguous but this was a little too much, I think.

The Graceview Patient by Caitlin Starling is a suffocating read, and I mean that in the best possible way. The author of The Death of Jane Lawrence bricks us into a tomb, essentially, with every chapter of her trippy psychological horror novel, which revolves around an unreliable narrator. What makes it more interesting than your average unreliable narrator situation, however, is that she knows she’s unreliable, but is powerless to do anything about it.

The character at the heart of this claustrophobic hospital gothic (a genre I never knew could exist until now) is Margaret “Meg” Culpepper, who has spent most of her 20-something years suffering from Fayette-Gehret syndrome, a rare (fictional) autoimmune condition that has destroyed her life — her skin is covered in painful rashes, her friends have given up on her, her parents never come visit, and she’s even had to stop her remote copywriting job all because of the exhaustion and discomfort Fayette-Gehret causes on the body. That is what drives her to sign up for an all-expenses-paid spot in a grueling experimental medical trial at the aging Graceview Memorial Hospital.

If she commits herself to the near-total destruction of her broken immune system, the doctors promise their treatment plan will regenerate a brand-new, healthy one in its place. It seems too good to be true, but Meg is desperate. A few weeks into the trial when her body starts to fail, she begins to suspect something sinister is lurking within the walls of the hospital, and it’s up to her to fight against both medication-induced delusion and the nurses keeping her locked up (for her safety, supposedly) in order to escape Graceview’s control.

Starling’s vivid prose immediately jumped out at me. She has a way of turning small, seemingly innocuous details into something foreboding or menacing — the hospital’s “politely decaying entrance,” or “the flash of arterial red” in someone’s yogurt, for example. That continues as Meg sinks deeper under Graceview’s influence. She soon loses the ability to tell what is actually going on, and what is an invention of a brain soaked in powerful experimental drugs. Like, did she actually tackle someone to the floor and cover them in her own blood? Was the conversation she had with the patient down the hall real? And what about Adam, the pharmaceutical rep who gives off major Misery vibes — are his intentions genuine, or is he Annie Wilkes with charm, slicked-back hair, and a sharp suit?

This general sense of disorientation is great for the novel’s overall atmosphere, but I will say I found it a burden on the storytelling. Meg remarks a few times that her brain is struggling to create a narrative from strands of tangled memories, putting them in an order that makes sense. I know exactly how she feels, since I was attempting to do the same with this book. The reader ends up trapped in the same endless loop of trauma as the main character; every time the story seems like it’s going to yield some answers, or evolve into something else, it reverts back to square one to start all over again.

That element of the plot is further exacerbated by the constant hinting of something ominous happening to Meg later on in the story — i.e. “If somebody would have listened to my lungs, they probably would have found it was already too late,” or “I should’ve left that day,” or “If only I’d done…” or “At least, that’s what she’d told me.” As if it should be followed by a cinematic “dun, dun, DUNNN.” That’s an effective way to create suspense if used sparingly. But every other page seems to end with a line like that. It gets old fast, and is especially frustrating when you take into account the book’s (somewhat) slow pace.

Those gripes aside, there is still a lot about The Graceview Patient that I enjoyed. Starling’s prose and dialogue are excellent, and the vibes are bleak as hell. It’s horrifying without being scary, in my opinion. (Though to be fair there is some body horror from time to time.) There are some interesting (and chilling) meditations on chronic illness and what it means to be sick in a capitalist society obsessed with work and productivity, too. This line in particular stood out to me: “When I first started getting sick, I had this romantic idea of it. I was miserable, yes — but at least it meant I finally had permission to rest. I’d be taken care of, instead of running on empty, all alone. Like a childhood sick day; I yearned for that simplicity, that safety.”

The idea of resting for resting’s sake is such a foreign concept in contemporary American society that many of us can only imagine such a scenario happening, where we get to rest guilt-free, if we’re gravely ill. That theme, coupled with Meg’s obsession with the restoration of objects (people on YouTube fixing up old tools and kitchen appliances, or the home renovation shows on HGTV that she binges in her hospital room), creates a damning look at the state of modern work and healthcare. Evil doctors and hospital beds turning into giant mouths that devour you whole are freaky, sure, but for me, Starling’s inclusion of those ideas is where the real horror of this novel lies.

Shout out to NetGalley and St. Martin's Press for the ARC in exchange for an honest review. The Graceview Patient is available Oct. 14, 2025.

This one started off strong, pulling me in with promise but ultimately, it left me feeling a bit let down. We’re taken deep into Margaret’s mind, unsure of what’s real, what to believe, or who she can trust. Normally, I love this kind of psychological unraveling, but as the story went on, I found myself waiting for a moment that never came. I expected a punch-in-the-gut ending or some kind of revelation that would reframe everything. Instead, it just... ended. I’m still not quite sure what I was supposed to take away from it. If you enjoy ambiguous psychological stories, this might work better for you but for me, it lacked the payoff I was hoping for.

One wild trip. I love an unreliable narrator and Meg is absolutely unreliable, bless her heart. I can't vouch for the accuracy on the medical stuff, but the palliative care aspects were on point. Would honestly love a sequel, just to see what comes next.

Thank you NetGalley and St. Martin's Press for an ARC of this title and the opportunity to provide an honest review.

This book was a wild ride. The hospital environment combined with the locked-in, is-this-real-or-not atmosphere had me hooked from the start. That eerie tension of not knowing whether something is actually happening or just a side effect of illness or medication created a gripping sense of unease. I love that feeling of being trapped, of not knowing who to trust, and this book delivered on that front really well.

That said, there were a few things that didn’t quite work for me. The fictional disease the patient suffers from made it a little harder to fully grasp the stakes. Because it’s not grounded in something real, I found myself unsure of how serious certain symptoms were meant to be or what was “normal” behavior for someone with this illness. Maybe that’s just how I like to read—I tend to need something to latch onto when it comes to the science or the rules of the world.

Another struggle I had was with the main character’s behavior. I understand the confusion and fear she was going through, and I could empathize with her being unsure of what was real. But some of her decisions—like breaking out of isolation and wandering the hospital halls with a potentially contagious condition—were tough to get behind. It was frustrating to watch her be so surprised by the consequences when she’d signed up for a medical trial in the first place.

Despite that, the premise had me completely invested and the character's situation was compelling enough to carry the story.

This was so creepy! The story is weird and unsettling in all of the best ways. I'm also a sucker for an unreliable narrator and I loved the way that this author built tension. I will forever be requesting every book that she writes!

I really love Starling's writing. This story had me tense and on edge the whole time - we never truly know what to believe is happening. I enjoyed it, but I do feel like I'm missing some resolution.

3.5 ⭐️

So suspenseful and although I’m not familiar enough with any medical terminology/diseases/protocols/etc., to comment on accuracy, the horror elements in the book were so creepy and intriguing to read. The mix of not being able to trust your mind & the body horror made it a very unsettling read.

Thanks to Netgalley and St. Martin's Press for the digital advance reader copy.

I really wanted to like this one as I've loved the author's other novels, but this feel pretty flat for me. The story failed to keep me invested and the style felt totally different from the author's usual voice.

Hospitals are fuckin weird, man. I had to spend a long weekend in the hospital earlier this year, and the whole experience exists in this sort of liminal mental space where I know it happened and what happened while I was there, but my memories of it are just kind of vague and half-formed. This book evoked those same feelings.

Things I did that caused my husband to ask if I was okay while reading The Graceview Patient:

Grimacing and squinting at the page so the book didn't know I was trying to read it.

Covering one eye so that the book didn't know I was trying to read it.

Closing my eyes for 30 seconds at a time so I could pretend what was happening on the page wasn't happening.

Keeping one hand on my forehead to keep my eyebrows from shooting off my face.

This book is great. This book is gross. I will probably never read it again, but I think everyone should read it so we can talk about it.

Gonna be a bit personal in my review for this one...

Having grown up in hospitals with my mom’s chronic illnesses and my working in healthcare, I’m not sure I know an outside world. Feeling trapped on the seventh floor with Meg is a home away from home. There were a few times I thought I would have to put this ARC away and not come back to it, but I’m so glad I did! My mom passed away May of 2022 after a long and exhausting hospital stay. Mentions of Covid-fatigue sent me into flashbacks of the ICU and step down. What a wild ride!

Meg has a brutal autoimmune condition that leaves her ‘normal’ life is a clouded haze. With no other remaining options, she turns to a clinical trial recommended by her rheumatologist.
Treatment? Cure? Paid?! Recommended by her trusted physician.. all seemed too good to be true.

As the days and weeks blend into one, is it just that? Too good to be true? With Meg having trouble pinpointing between reality and hospital delirium, we take a fast and steady progression of her illness, the treatment, and friends (or foes?) we meet along the way.

This story takes a turn in every way I wanted it to, and hoped it would. I’m an odd one; I thoroughly enjoyed being in the hospital the entire ride. From the window views, to the garden, the basement hall,.. I felt like I was right there with her; enduring each day.

I could go on and on about this book! I’d really love to see a continuation of this story.
I hadn’t heard of Caitlin Starling, but this will not the only book I’ll read!
Thank you for this book!
Thank you NetGalley and St. Martin’s Press for the ARC.

Caitlin Starling does it again! Deeply unsettling, but obviously written with care. As someone who has somehow been through something oddly similar to the clinical trial Meg is undergoing throughout the book, this got right under my skin and will be staying there for a long time.