3 stars.

Margaret Culpepper has a rare autoimmune disease and signs up for a medical trial in an attempt to "cure" her, by tearing down her immune system and rebuilding it. In order to do this, Margaret is subjected to tests while remaining at Graceview Hospital, which seems to come alive around her.

This was my first delve into medical/hospital horror, and it was a good read. Margaret becomes quite the unreliable narrator as she goes further and further into the program and begins to hallucinate, which eventually made you question what was real and what wasn't. The cast of characters isn't too big and you didn't seem to know their true intentions and if Margaret should trust them or not. I loved the hospital becoming alive and it's quite descriptive, but I do wish the end was less of a cliffhanger.

3.5 stars, rounded up to 4 stars.

I'm normally not very interested in medical horror, but I was invested in this one. The author successfully pulled off creating drama and danger in the unit, and developed characters that were unique and added to the tale.

The whole fever-dream episode worked a little less well for me, but I can see where it came from.

The ending seemed a bit abrupt, but I didn't feel unsatisfied at the end.

Will I read more from the author? Yes.

I received a complimentary copy of the novel from the publisher and NerGalley, and my review is being left freely.

Caitlin Starling managed to capture the trauma of being a woman in the United States healthcare system, and turn it into an all out psychological war of a horror novel.
It’s beautifully written, it’s heartbreaking, and it’s perfect. Following our unreliable narrator (poor, poor Meg) down these twists and turns was so perfectly scary and frustrating. Caitlin is an auto-buy author for me, and this was one of my most anticipated novels of the year; it didn’t disappoint :]

Another goodie from one of my favorite horror authors! It was the realistic hospital experience, combined with the paranoia and distrust of people who should be there to help you, that really unnerved me. The helplessness of being a patient, the clinical coldness of the doctors and nurses, the spiraling confusion of being on strong medication, and the hollowing emptiness left behind at the end of the stay: these are the elements of the story that haunted me the most.

Fun ride! I was Fully engaged for most of the story with lots of twists and turns and weird stuff happening. But then the end is open! I really Don’t enjoy that so knocked a couple of stars. Thank you to NetGalley for an advanced copy.

The Graceview Patient had all the right ingredients: eerie institutional setting, psychological twists, and a creeping sense of dread. But the execution? Didn’t land for me. The tone felt too clinical to be unsettling and too distant to be immersive. I couldn’t get into the rhythm of the writing — it kept me at arm’s length when I wanted to be pulled under.

The concept is solid, and I can see it working for others, but stylistically, this one and I just didn’t jive. Sometimes it’s not the story — it’s the telling.

3.5

This book isn't going to be for everyone. It's a first person account of medical trials in a hospital that feels very claustrophobic and highly unsettling.

Read this book if you
- like a slower burn
- don't mind an unreliable narrator
- "the call is coming from inside the house"

Maybe skip if you
- need conclusive evidence
- are squeamish of blood and other bodily fluids
- are looking for something in your face

3.5/5 Part thriller, part fever dream, this story takes us inside a medical facility where Margaret is being treated for a rare condition. Overall, a fun and crazy ride, docking half a star because with an ending like that this book really needs an epilogue.

Atmospheric as hell, The Graceview Patient really sunk me into the misery of chronic illness and a long hospital stay. Although anyone would go a little nuts under these circumstances, the main character Meg starts to <i>really</i> slip in a way that did keep me compelled for all that the days were not dramatically dissimilar. The ending did not hit the way I wanted it to, but for better or worse I'll remember the experience!

My thanks to St. Martin's Press and NetGalley for the ARC.

I honestly don’t know how to feel about this book. It definitely shows that reality isn’t necessarily reality. It mostly makes me wonder what happens next. What happens to Isobel and what happens next to Meg. It was a great book, I smashed reading it in a day. I definitely kept my interest. I just have so many unanswered questions and I want some resolution. Great work, sucks you in!

Margaret (Meg) Culpepper has been plagued by a rare autoimmune disorder, known as Fayette Gehret Syndrome. The condition, which affects the cells that form a protective barrier on her skin, digestive tract, and respiratory system, has no cure, leaving Meg to an unsustainable, isolated life filled with pain and hopelessness. So When Meg is offered a paid spot for an experimental treatment at Graceview Memorial hospital, she readily takes it, despite the requirement to live at the hospital full time and submit to a nearly total destruction of her immune system.

Yet, nothing is as it seems. As the trial proceeds and Meg slowly feels herself succumbing to her worsening conditions, she begins to notice a darkness throughout the halls of Graceview Memorial, leaving her to wonder if something much more sinister is unfolding.

The Graceview Patient is deliciously creepy. I was extremely anxious and confused this entire book and I loved every second of it. Say what you will about media giving you negative feelings, but I live for a book that toys with my emotions like this.

Meg is an unreliable narrator, to a point where I got to the end of this book and genuinely had no idea of what was going to happen. I won’t spoil the ending, but (and I know these are HUGE comparisons) it almost reminded me of 1984 or One Flew Over the Cuckoo’s Nest (If you know, you know. If you don’t, I’ll leave it at that so you can experience the unraveling yourself). Just when I thought I had everything figured out, the twist ending smacked me with even more questions, albeit in a very entertaining way.

I really enjoyed the characters. Though filtered through Meg’s fairly distorted lens, the people around her felt layered and compelling. The hope and desperation that Meg projected onto Veronica and the kind, endearing friendship she formed with Nurse Isobel were both beautiful and heartbreaking. But the character relationship that intrigued me the most? Adam, the pharmaceutical representative for Meg’s trial. He gave major “Hans from Frozen” energy, charming, unreadable, and extremely morally ambiguous. Even after finishing the book, I am still unsure of whether he was a hero or a villain. Maybe both.

As much as I enjoyed the ride, I think a lot of elements were too reminiscent of other books and movies that I loved. This isn’t necessarily a bad thing, but I didn’t feel like I was absorbing anything new, making the book read a bit slower than it should have. I didn’t predict the ending, but many of the smaller twists were pretty easy to spot if you have spent any time with the thriller/horror genre.

While the medical anxiety is effectively written, I do think it would’ve hit harder a few years ago. We’re over five years out from the start of the pandemic, and though the book taps into feelings of isolation and vulnerability that were all too relatable in 2020, I felt a little too far removed now to fully relive that intensity. it resonated, but it didn’t haunt me in the way it was meant to.

While I enjoyed the ending, I wish it has been a bit more conclusive. The final pages are abrupt in a way that works thematically, but I would have liked to know more about what happens next. Meg suffers so much throughout this book and I really felt bad for her. The way her story ends, though productive to the story, does not do her character justice in the way she deserves.

2.5 rounded down to 2

I was really excited to read this after reading The Starving Saints this year (which was my first Caitlin Starling book btw and I LOVED it. Looking forward to reading Last to Leave the Room) and idk... this was something...

I wasn't sure how I felt at the start of this book. The idea of an unreliable narrator being trapped in a hospital during a medical trial was interesting. But the narration was fine, the actual narrator was hard to connect with, and the story was being stretched way too thin. I feel like I could've skimmed portions and still have gotten the same experience.

I also need to address that the ending was very abrupt and left a lot to be desired. Literally I went "that's it" after reaching the final page. There was a lot that was left unresolved and made the whole experience just a little more frustrating.

For this book, the writing style grew on me as the book went on. The main character is unreliable, which I love in a book and I thought it was intriguing to read her descent into madness. The ending wasn't as good as I hoped, but the book was good overall.

Special thanks to NetGalley and St. Martin's Press for an advanced copy of this book in exchange for an honest review!

This is one of those horror books that truly gets under your skin. There were a few times I had to put the book down and take a few breaths before continuing on because the horror is just SO palpable. The story takes place in a hospital and the body horror is HEAVY in this one. The mix of patient confusion, potential hidden agendas of the hospital staff, and an all out rollercoaster of a story really made this book soar.

Caitlin Starling has a way with words that truly gets under your skin. You feel the emotions the characters are feeling. For a novel like this, the anxiety and pain is HIGH, you are incredibly worried for the main character, and each page is turned as fast as you eyes will allow. I could NOT stop reading this book, even though sometimes I needed to break from the sheer horror of what was happening in the story.

That being said I do have to agree that the ending was lackluster at best. The story ends at a point that I would NOT consider the end of the story. As a reader I still have many questions about what is going on, and what is supposed to be happening. Things start to get hazy and confusing by the end so there is no fancy bow to wrap the whole story together. I am hoping maybe that will lead to a second book, like a cliff hanger of sorts? But, if I'm being honest with myself, I wouldn't know where the story could even go once a couple of small details are answered (that could've been answered in this book). It could just be that Starling wanted it to end in a haze and I can see that, but for me as the reader it let me down =(

All in all, a REAL horror book!! Hospitals gone wrong on steroids to the MAX! It is a fun read, a sickening read, and although the ending isn't the best, I still really enjoyed this one! Easily one of the best horror books for that creepy body horror uneasy type feeling!

The majority of this novel is just a realistic view of chronic medical care and does an incredible job of portraying the fear, paranoia and pain associated with that. It is true horror in that sense. The conclusion was . . . I don't know about that part. But the writing, as is all her writing, was very evocative and beautiful.

This book is NOT for the squeamish! There were plenty of moments where I had to gently and quickly read through because-whew-medical horror is graphic! I’m thoroughly confused, creeped out, and also confused. Which I think was kind of the point when you have an unreliable narrator. Is she hallucinating? Are the staff lying to her? What is wrong with her?

Meg is one of the few unlucky sufferers of a rare chronic illness, Fayette-Gehret syndrome. When a paid clinical trial is offered to her, she decides to take the plunge, unsure what she’ll find on the other side.

This contemporary medical horror is jam packed with bizarre fever dreams and body horror. A psychological thriller with an unreliable narrator, this one will have you feeling like your sanity is slipping away, unsure who you can trust.

A solid read and creepy read, the ending has me scratching my head and feeling like I need to read it again. This would be a great book club read if only to discuss with other readers what their impressions were from a highly subjective story.

Thank you to St. Martin’s Press for providing this book for review consideration via NetGalley. All opinions are my own.

Thanks to NetGalley for the ARC!

I really wanted to love this one—the cover is gorgeous, and the premise sounded so cool. But overall, it just didn’t fully work for me.

The pacing felt really slow, and I had a hard time staying engaged. The relationship with Adam (spoilers!) felt kind of weird and didn’t feel natural to me at all. Plus, the setting barely changed, so things started to feel a little repetitive and flat as it went on.

That said, I still liked the concept and the vibe—it just didn’t fully land for me.

3/5 stars

Out October 14th, 2025
The Graceview Patient delivers a cerebral dose of dread that prickles under the skin rather than jumps out at you. Set within the confines of a research facility that feels more like a tomb than a sanctuary, this thriller chills with its clinical precision and mounting paranoia. Starling crafts the atmosphere like a scalpel—sharp, sterile, and slowly cutting into something sinister beneath the surface.

The horror here isn’t loud—it’s procedural, psychological, and laced with ethical unease. As the protagonist unravels the truth about a mysterious patient whose symptoms defy diagnosis, reality begins to blur in disturbing ways. The pacing drifts in the middle, occasionally stalling in technical detail, but just when you think the terror might taper off, it hits you with disorienting intensity. There’s a patient—and a past—that refuses to stay buried.

Ultimately, this story succeeds more as a mood piece than a plot-driven shocker. It’s unsettling in all the right places, though some twists feel more clinical than cutting. For fans of unnerving medical horror and morally grey science fiction, The Graceview Patient offers just enough dread to keep you up at night... but maybe not every night.

Thank you for the spooky good ARC, NetGalley and St. Martin's Press!

As always Caitlin Starling hits that perfect middle ground of terror and tension that make her works impossible (for me) to put down. Covering a truly terrible time with an experimental treatment for a niche (and fictional) autoimmune condition, The Graceview Patient build and builds as Margaret's experience deteriorates. Starling captures the chronic illness experience well as well as the ramifications of autoimmune diseases and their treatment. As expected, there is a fair amount of body horror and medical grossness but not to an unbearable level. This is a book for those who like a bit of horror mixed with their psychological thrillers - and while I was pleased with the ending I can imagine readers who would not be.

A heartfelt thank you to NetGalley and St. Martin’s Press for a ARC in exchange for an honest review.