The Graceview Patient by Caitlin Starling follows Margaret (Meg), a young woman who has been living with a rare disease for quite some time. Upon hearing of an experimental trial at Graceview Memorial, Meg agrees to have her immune system destroyed and reconstructed, leaving her stranded in the care of Graceview's staff. As her treatment continues, the lines between terror and reality begin to blur, leaving Meg to wonder if she's truly safe at Graceview.

I really enjoyed the beginning of The Graceview Patient! It began with a vaguely ominous atmosphere, creating a really suspenseful start! There is a sense of so much happening behind the scenes that the reader (and Meg herself) is unaware of, which ratcheted up the tension. Unfortunately, I felt like much of the suspense was lost as the book progressed and it became more clear what was happening to Meg. I would've really liked to see this head in a much more wild direction,

This book came so close to being outstanding. The story was just creepy and mysterious enough to keep me invested and the descriptions of the hospital were revolting and absurd enough to tie in so well with the story that I am still trying to figure out if they were real, or if our heroine was out of her mind.

Thank you to NetGalley and the publisher for the ARC!

This is my second book by Caitlin Starling and I think she definitely has a knack for writing slow, isolating thrillers. The writing style is great and I loved the descriptions of Meg's physical illness and the horror around her.

After so much development, the ending felt abrupt and open ended. While I didn't think the ending was perfect, I'd definitely still recommend this book for anyone looking for a medical/psychological thriller with horror elements.

The Graceview Patient is my second Caitlin Starling book that I received in eARC format this year. My girl is flying through the publishing process.

Meg is sick. Really sick. The kind of sick that most people cannot fathom. When she is offered a clinical trial that aims to break down and rebuild her immune system, she decides that she has nothing left to lose and sets off for the long-term hospital stay. Things in the hospital appear normal - if a little boring - until one day Meg meets her new nurse, Isobel. Isobel is no-nonsense and has only one message for Margaret - GET OUT.

I was skeptical of this book. The Death of Jane Lawrence was one of my biggest let-downs in 2021 and I was prepared for my heart to be broken again by this title. Caitlin Starling has clearly come a long way in her writing, because this book sunk its teeth in, shook me like a dog, and dropped me when it was done [compliment].

I personally suffer from a random assortment of chronic illnesses. None are quite as serious as what Meg is going through, but I could relate to her frustration and isolation. There is a scene where she describes how many of her friends gave up on her after numerous canceled social plans that broke my heart a little. Even without that medical connection, though, Meg is likable. She's been caught in the wheels of something bigger than she is, which is something most of us can relate to. Whether it's a job, school, a hospital stay, or even just a quick visit to the ER, we have all been at the mercy of some gaping maw of industry that we are forced to kowtow to. We all know how frustrating it is to see a problem and not be able to get anyone to meaningfully listen to you about it.

I'm a personal fan of books set in hospitals, and I felt this one really captured the hum-drum of existing inside of one. Granted, there is a lot more spooky shit going on than in your local medical facility (I hope) but the more mundane aspects like blood draws, IVs, and trying to get ahold of a doctor that is far too busy to be bothered with you felt pretty standard for the medical experience.

As far as the horror aspects of this book, I think that this will be the part that divides the most people. The Graceview Patient is one of those books where you just need to go along with where the book takes you. It's a weird, fever dream of a ride and there are not perfect answers to the mysteries that the reader is presented with. I found the descriptions to be pretty gnarly at times and really liked where the story ended up, but I think that some people definitely will be annoyed with the fact that much of the details are left up for interpretation.

I would definitely recommend this book to people looking for a fresh, new horror title for the year. Horror tropes happening in a hospital certainly aren't new, but the aspects that the author chose to add in make for a really fun, tense, claustrophobic story.

Thank you to St. Martin’s Press and the author for an advanced reader copy of this book. The premise was good, and I thought the writing was great. The last 25% of the book got a bit off the rails in my opinion, and it went in a direction that was a bit too “out there” for me.

3.5 stars rounded up

This took me a long time to get through, but I'm glad I stuck through it. It was atmospheric and claustrophobic, which I enjoyed in this setting. However, I found the ending was abrupt and disappointing, as there were many unanswered questions.

As someone with an autoimmune disease - The Graceview Patient really captured all of the fear and uncertainty one experiences throughout the process of diagnosis / treatment. I can see the ambiguous ending ruffling some feathers.

Book reviews by the very nature of their subjectivity are hard to write. I’m a great fan of “closed circle” settings. This entire novel’s setting, for the most part, is a hospital room. A+. I’m a great fan of books that concentrate on character development to propel the plot rather than a lot of action. Not to say this book doesn’t have its share of movement and tension that’s built beautifully by the author. A. I’m a great fan of multi faceted characters. Neither all good, nor all evil. Neither unabashed hero nor dastardly villain. At times confidence, at times self doubting and unsure. In other words, human. A.
Some may find this novel slow moving but that’s ultimately the interesting aspect of art, it’s subjectivity.
Personally, I couldn’t wait to get back to enjoying it.

This made me feel all kinds of icky and gross. Especially, and I won't spoil it entirely because if I have to suffer than so does everyone else, that goddamn shower scene is incredibly graphic. I actually almost puked. So congratulations, Caitlin Starling, you win.

Whether it's a medieval stone castle facing starvation and monsters (as in the Starving Saints, my introduction to the author) or a creepy hospital room, Starling skillfully immerses the reader from the very beginning. Luring you to this liminal space before forcing you into a choke hold of body horror and hallucinatory experiments.

Having your autonomy stripped from you is a nightmare all its own, but to be in a hospital with no sense of familiarity or comfort or support outside of the medical staff and something strange happening to your body that you can't predict or control is...what's worse than hell? Because it's definitely whatever that is. This book really, truly reminds me to be so grateful for the relatively minor health pitfalls I face, at least compared to someone like Meg. It's terrifying because it reminds the reader that medical disability can happen to anyone, that THIS can happen to you or me at any time.

I loved the uncertainty of the narrator's reality. We're certain things are happening because that is what she's  experiencing, but we're also told with certainty that none of it is real. The story and ending are ambiguous enough that you're never quite sure if there was any malicious intentions at all.

The Graceview Patient is slow to get into, but once it ramps up, you can't put it down. You don't want to, because you need to know what happens to Meg. To Isobel.

Thank you to St. Martin’s Press, NetGalley, and the author for this ARC in exchange for an honest review.

Thanks to NetGalley, St. Martin's Press and
Caitlin Starling for the advanced digital copy.

I loved the creepy ,claustrophobic hospital setting of The Graceview Patient.
This was super eerie and gave me a feeling of dread that kept me wanting more. It’s a mind bending and suspenseful dive that will have you wondering what is real and what is imagined.

This was my first Starling book and I cannot wait to read another!

Margaret has an unfortunate life and a rare disease that keeps her constantly ill. A unique opportunity presents itself as she’s accepted into a study to destroy the body that’s keeping her sick and totally rebuild her immune system to cure her. As she begins this road the meds and research take a toll and she can’t begin to tell if it’s a hallucination or real life. A book that keeps you guessing till the end and then still wondering it was a wild ride. 3.5 stars.

This book had a slow burn that reminded me of Mexican Gothic. It made you truly question what was reality and was imagination. Once it hit a fever pitch I could not put it down and read the last 100 pages in one sitting.

The Graceview Patient is a slow, tense unraveling of body and mind, and it’s one of the most unsettling books I’ve read in a while. Margaret signs up for a last-resort medical trial for her rare autoimmune condition, knowing it’ll be grueling—but as the treatment progresses, things at Graceview Memorial start to feel off in ways that can’t be explained away by medication side effects alone.

The medical horror is grounded and detailed, which makes it all the more disturbing. Starling doesn’t shy away from the physical toll of chronic illness or the emotional cost of being trapped in a system that demands total compliance. Margaret’s experience feels real—isolating, exhausting, and increasingly surreal as her sense of what’s real starts to blur.

What really works is the atmosphere: sterile, cold, and increasingly claustrophobic. The tension builds gradually, and the line between delusion and something more sinister stays just hazy enough to keep you guessing. Margaret isn’t always likable, but she doesn’t need to be—she’s sharp, skeptical, and fighting to keep a grip on herself in a place that wants to take everything from her.

This isn’t a fast-paced thriller, but it’s effective because of that. It sits with you, lets the dread build, and lingers after the last page. Definitely recommended if you like your horror smart, character-driven, and just close enough to reality to make you uneasy.

Thanks to NetGalley for the ARC.

Another Caitlin Starling hit for me! I think hospitals and losing control of yourself are some of the scariest things in the world, so this was very much up my alley. Similarly, the way your autonomy can be taken away, the way women will be viewed as hysterical for having health concerns, insurance keeping us from seeking care elsewhere, it's all woven together in a way that isn't too heavy-handed but reminds the reader that parts of this horror could happen to you. Devoured this book in three sittings because I needed to know what happened - last night I stayed awake far past my usual bedtime because developments just kept coming and I needed to know more. I loved that our narrator is told she's experiencing paranoid hallucinations but we experience them with her, and are fairly confident some of them are happening, but it's left ambiguous and mimics her own state of mind as she wonders what to believe. So creepy and haunting!

Thank you so much to NetGalley, Caitlin Starling, and the publisher for an ARC of this book!

Okay so — this one was a ride. Picture a hospital that feels more like a haunted asylum, a medical trial that sounds sketchy even on paper, and a main character so raw and real you kinda wanna wrap her in a blanket and smuggle her out of there. It’s slow-burn horror meets total fever dream, and I was honestly here for it.

The atmosphere? Claustrophobic in the best way. Like you can almost smell the antiseptic and hear the weird hum of hospital lights flickering overhead. I loved how it blurred the line between hallucination and reality, to the point where I stopped trying to guess and just let the story carry me off into the weird. And it was weird. Deliciously weird.

Now, I will say — the ending left me like wait, that’s it?! after everything we’d been through. I could’ve used a little more payoff after that mental marathon, but honestly, sometimes horror works better when it leaves you slightly unhinged and unsatisfied. Keeps you thinking about it, you know?

All in all, a gorgeously gross little gothic nightmare that’s perfect for anyone who secretly loves freaking themselves out. Big thanks to NetGalley for the ARC in exchange for my honest thoughts!

Attention Netflix- I just found your new hit show.

I was obsessed with this from start to finish.

It was so good-and the ending was the worse, but i love it.

Thank you NetGalley, Caitlin Starling, and the publishing house for this amazing Arc.

An unhinged, fever dream of a wild ride! The Graceview Patient plays so perfectly on fears of losing your mind, loss of control, and patient abuse.

Margaret’s life has been completely upended by a rare autoimmune condition. Isolated and running out of options, she accepts a spot in an experimental medical trial at Graceview Memorial Hospital. The trial is extreme—she must live full-time in the facility while undergoing treatment that will basically destroy her immune system, with the hope of rebuilding it. However, as the treatment intensifies, Margaret begins to notice strange things happening inside Graceview. Something unnatural is spreading, lurking in the corners of the hospital—and no one else seems to see it.

This one took me a little while to settle into (I’d say around the 35% mark), but once it clicked, I was fully invested in the main character and the eerie unraveling of the plot. Starling does an incredible job capturing the emotional weight of chronic illness—the desperation, the decisions, and the terrifying vulnerability of putting your body in someone else’s hands. The tension builds gradually, and the creeping horror pairs so well with the very real medical dread. The detail and atmosphere really pull you in, and while it wasn't a perfect read for me, the story lingers. It’s unsettling in the best way, and definitely worth the read if you like your horror slow-burning, emotionally complex, and just a little too real.

The book is my worst nightmare in story form. Hospital settings, medical trials, and paranoia are all present in this locked in hospital settings I was unsettled the entire time and I am still unsettled now.

My Thoughts
What Margaret Culpepper's character went through during the course of her clinical trial treatments sounds like something out of the worst nightmare one could have happen and still somehow stay alive.

Unlike what she actually thought she signed up for Margaret became part of something quite different and unfortunately for readers the books ending in no way, shape or form was concluded to my satisfaction.

I suggest you be prepared to be horrified, revolted and shocked while reading.

A psychological suspense horror story unlike any I have read thus far.

The story is a strong one but it is definitely not for the faint of heart with its vivid graphically described imagery that is both grotesque and informative to the reader.
[EArc from Netgalley]
On every book read as soon as it is done and written up for review it is posted on Goodreads and Netgalley, once released then posted on Amazon, Barnes and Nobles as well.