I enjoyed how unique this was as a horror. This gave me goosebumps and sent shivers down my spine in ways a horror hasn’t in so many years. It’s not your run of the mill horror story, and I liked that. It was slightly dystopian, but wasn’t like the average dystopian horror I’m used to reading. I couldn’t stop reading this and finished it in a day. It was a great read.

Having previously read The Death of Jane Lawrence and finding it somewhat disappointing, I approached The Graceview Patient with a mix of curiosity and hesitation. This time, however, Caitlin Starling delivered a gripping and unsettling experience that far exceeded my expectations.

The novel follows Margaret, a woman suffering from a rare autoimmune disease that has left her life heavily restricted. Seeking a chance at recovery, she enrolls in an experimental medical trial at Graceview Memorial, a hospital offering an extreme treatment that essentially destroys and regenerates her immune system. As her condition deteriorates, it becomes clear that something far more sinister is unfolding within the hospital’s walls. The question of whether the horrors she experiences are real or side effects of her treatment adds an intense psychological layer to the story.

One of the strongest aspects of this book is its claustrophobic, immersive atmosphere. Starling creates a deeply unsettling setting where isolation and vulnerability become almost tangible. Margaret’s character is incredibly well-developed, making her journey through both physical and psychological torment all the more compelling. The blend of medical thriller and psychological horror is executed with precision, keeping the tension high throughout.

Unlike The Death of Jane Lawrence, which felt like it didn’t fully deliver on its premise, this novel held my attention from start to finish. The eerie, slow-burning tension worked well, and the medical horror elements felt both fascinating and terrifying. This book has renewed my interest in Starling’s work, and I would definitely recommend it to those who enjoy unsettling psychological horror with a medical edge.

The Graceview Patient by Caitlin Starling is a terrifying look at the experience of a clinical trial in an isolated hospital setting.

As a member of the medical field, I have to give Starling the utmost credit for including factually accurate hospital details throughout. That is one of my biggest pet peeves of books with a medical setting. Our main character, Meg, is living with Fayette-Gahret Syndrome, an autoimmue condition that is eating away at her body. Her symptoms have left her isolated and alone, jobless, and broke. When the opportunity to join a paid clinical trial that promises to breakdown and rebuild her immune system presents itself, she takes it. She checks in, telling only her mother that she is joining, and so begins the isolated process of undergoing intense infusions as part of the clinical trial.

We follow along with Meg as she develops relationships with other patients, the nursing team, and the members of the clinical trial staff. She experiences horrendous side effects, including hallucinations, leaving the reader frequently guessing what is "real" and what is her hallucinations.

While I really enjoyed her progression as a character and the relationships she develops along the way, as well as the excellent descriptions of the hallucinations, the ending was a huge letdown for me. I am not entirely sure what the novel was trying to SAY. The main character seems to go through this huge learning experience as part of the trial and then just (spoiler) agreed to stay and do more? For all the heroics of the last 15% of the book, this didn't make any sense to me.I think that it would have benefitted from an author's note.

Overall, a fast, entertaining read, but not one that will stick with me long term.

The Graceview Patient, written by Caitlin Starling, is sure to give you the heebie-jeebies in this gothic horror/thriller novel. A young woman, just 26 years old, is suffering from Fayette-Gahret Syndrome, which leaves her incredibly vulnerable and in pain. When the possibility of a trial drug comes her way, she can’t pass it up: despite her shoddy medical insurance, the entire hospital stay would be covered and in the end, she could potentially be cured.
Due to the rarity of Fayette-Gahret Syndrome, there is only one other patient on Floor 7, where she would spend the entirety of her stay should things go well. But, the longer that Meg stays at Graceview, the stranger things become.
It is a strange, claustrophobic novel that left me wanting to turn page after page to find out what happens next. Meg is an incredibly unreliable main character – as we the readers begin to question is what is happening to her is truly happening or if it something that her overly medicated mind is conjuring up to share with us. It is not every day that makes me say that the main character is unreliable, but there is simply no other word for Meg throughout. Is she seeing things? Or is what is happening to her only happening to her in her mind? This question continues even after the novel is finished.
Thank you to Netgalley, St. Martin’s Press and Caitlin Starling for the opportunity to read this advanced copy of The Graceview Patient. The opinions mentioned are my own.

Marvel Metamorphose meets Shutter Island in this epic thriller. You are really not going to believe who or what is going on by the end of the book.

Oppressive and filled with the feeling of the room closing in around you, of losing your ability to escape, of realizing the hopelessness of your situation - The Graceview Patient is another phenomenal read from Caitlin Starling.

With an unreliable narrator as our main character - often from the drugs of the experimental treatment given to her - we are never certain what is real and what is a hallucination inflicted. How much of what is going on is actually happening? Even when we get to the end of the novel, with the reveal and the understanding of what, exactly, is going on - we (as the reader) have the understanding that everything we’ve just experienced could be not real.

Told as if our main character is recollecting all the events that brought her to her current situation, we are given hints and clues about how everything ends for her - even while she is hopeful for the best in the current timeline. We are given little red flags about her isolation, her precarious situation, and the inability to trust those around her in the statements she makes about what is going on in her recollection. I loved these because it upped the eeriness of the novel, even when nothing is actually happening yet, because it primes us to look for the other shoe to drop before there’s even a shoe to drop. I also love how it sets us up to believe everything our main character experienced is actually happening as she’s describing it, and not the very likely possibility that much of this is a delusion created by the cocktail of experimental drugs she is being subjected to.

Filled with intense medical situations, I found this book personally hard to read at times. I do not like things like needles or surgeries or the like, and found those parts a bit difficult to read. However, while going into detail I never felt like this book went so far into the medical horror aspect that it was unbearable, unless your phobia is so intense that even discussing such things would be upsetting.

I loved this book and found the medical setting lending to a kind of hopelessness throughout the novel, as once the events truly begin to unfold our main character has absolutely no one to vouch for her. Anyone who is a fan of medical horror where you can’t trust your own memories or experiences, along with a trapped room/location where it begins to feel like the walls are closing in, would love this novel.

A huge thank you to the author, NetGalley, and St. Martin’s Press for providing this e-ARC.

Didn't really care for this one. It started off fascinating—the main character checks into a hospital to receive an experimental treatment for an autoimmune disease she has. Right away, things are strange, and the longer she's there, the more worried she gets.

But, unfortunately, it didn't live up to its potential. The story eventually turned a bit odd and I didn't really get the ending. <spoiler>Was the disease actually an alien organism? I think it was, but I'm not sure!</spoiler>

Thank you to NetGalley and the publisher for providing me with a free copy.

Unable to finish. Not my cup of tea. I just could not get into this book, which is a first person account of a nightmarish stay in a hospital as part of a clinical trial. After slogging my way through the first six chapters I gave up. I went through each of the remaining 32 chapters, reading the first few pages to confirm the tedious storytelling and writing style remained consistent (it does) and read the final chapter just to get some closure on the tale, which was completely unsatisfying and made me glad to have not invested more time reading the book.

Disclosure: Received an uncorrected ARC of this book from NetGalley and St. Martin's Press (Thank you!) in exchange for an honest review.

Caitlin outdoes herself with this one. The Graceview Patient is raw and real, and also confusing with a very unreliable narrator. I felt a deep connection with MC Margaret (Meg). I have an autoimmune disorder and have spent more time in hospitals and doctors' offices than I have working. Caitlin gets the details down so well, even to the little chlorhexidine ring they slip between a port access catheter and your skin (I had a port-a-cath). I felt connected to Meg, in a way I may never be to other characters. Caitlin tells such a good story through Meg's tired, disoriented eyes, that it keeps you turning the pages.

I thought "Last to Leave the Room" was my Starling favorite, but this just stole my heart.

Thanks NetGalley for the ARC of The Graceview Patient by Caitlin Starling published by St. Martin's Press

I enjoyed this book, I would say it starts psychological thriller and turns to horror. I certainly didn't expect some of the turns this book took, in a good way.
Margaret is the main character and is affected with Fayette-Gehret syndrome, a rare skin disease. She has been offered a free stay in a hospital to be cured, she wonders what the catch is, as her condition is so rare. She accepts the offer and so begins her extended stay.
The author does a great job with characters and their introduction in a timely manor. The story starts out so normal and takes a turn for the weird and horrific part way through
This story went from strange to stranger, trying to figure out what was real and from whose perception. Is Margaret sane, hallucinating, what is real vs drug induced.
Very creative horror story. The medical aspect of Megs stay felt a little repetitive at times, such as the descriptions of what she was subjected to on a daily basis, but nothing that kept me from  putting the book down, this was a page turner for sure.
It's the first of this author's novels that I've read and will be definitely reading more

Margaret (Meg) Culpepper's last hope for treatment for the rare autoimmune disorder, Fayette-Gehret Syndrome, which has taken almost everything from her, was checking into Graceview Memorial. The hospital is running a two to three-month-long medication trial treating the disorder, but even though Meg's life had become unsustainable, taking part in the trial means she must break her lease and give her time and body over to the hospital. Meg expects to be prodded and poked, to be subjected to blood draws and IV medication infusions. Still, the longer she stays at Graceview, the harder the treatment is to endure, physically and psychologically. Gradually, her sense of reality becomes increasingly distorted as she is enveloped by the horrors and darkness of the hospital. Is the medication causing hallucinations and drug-induced delusions, or is the hospital harboring something more sinister?
 
Not for anyone squeamish about medical procedures, The Graceview Patient treads a fine line between psychological thriller and medical horror. Meg begins the trial with mixed expectations and anxiety, and depending on the reader's anxiety about medical procedures, this will affect their experience. Most of the tension and paranoia that make this an absorbing read are derived from the mystery treatments coupled with Meg as an unreliable narrator. Meg's journey through her treatment is an emotional and atmospheric experience, unfolding slowly; the pace is fitting, considering the length of the trial, lending itself to all matters of distortion.
 
If you're remotely fearful of hospitals, this will likely be a torturous read since every procedure is described in detail. This won't phase everyone, and in fact, it heightens the horror. As someone who deals with a chronic illness and has been through all kinds of procedures and has been stuck with a needle more times than I can count, I fully appreciated Meg's search for symptom relief, her feelings of helplessness within the medical system, and how isolating and lonely chronic illness feels. Even when it's hard to like Meg, author Caitlin Starling portrays her as someone who is justified in asking questions, as her life is in the hands of others. The story would only be strengthened with greater emphasis on the supernatural and sinister themes that haunt Graceview, as these are the root of the actual sickness and horror in the hospital.
 
Thank you to St. Martin's Press and NetGalley for the advance reader copy. #SMPEarlyReaders

𝑨 𝒉𝒐𝒔𝒑𝒊𝒕𝒂𝒍 𝒊𝒔 𝒂𝒏 𝒐𝒓𝒈𝒂𝒏𝒊𝒔𝒎, 𝒕𝒐𝒐. 𝑻𝒉𝒆 𝒑𝒆𝒐𝒑𝒍𝒆 𝒊𝒏 𝒊𝒕 𝒌𝒆𝒆𝒑 𝒊𝒕 𝒄𝒍𝒆𝒂𝒏, 𝒌𝒆𝒆𝒑 𝒊𝒕 𝒇𝒆𝒅, 𝒌𝒆𝒆𝒑 𝒊𝒕 𝒂𝒍𝒊𝒗𝒆.

I don’t know. I’m still so confused about everything. There were answers, but not definitive because we still have no idea what is real and what isn’t.

We’re put into the POV of Margaret who has a very rare autoimmune disease. She’s all but given up on life until she’s elected to participate in a new treatment to cure it when there is none. Everything is shady from the get-go. There isn’t a lot of information on the study, but she goes along with it anyway. I don’t blame her for that. It’s either give up or try, right? What’s the worst that could happen?

There isn’t much that goes on the first 60%-70% in the book other than Margaret going through the day to day lab test, withdrawals, and trying to keep her sanity while being stuck in a hospital ward. I really liked the fever dream and “what’s reality?” aspects, but I felt like I had to drag myself through 200+ pages to get to anything juicy. I’ve read medical thrillers/horrors before and while this was definitely creepy, wtf, and who to trust, it was too slow paced for me. I did love that the ending was left open for another book. I’d most definitely read one about this next phase, even if it’s just to satisfy my curiosity over everything and everyone from The Graceview Patient!

Thank you so much to the author, St. Martin’s and NetGalley for the gifted copy!

“The mind abhors chaos. It cannot abide randomness. It needs a narrative, one event after another, reason and cause and effect. When life is at its most incomprehensible, the mind clings to narrative the tightest.”

Thank you NetGalley and St. Martin”s Press for the advanced copy in exchange for my honest review.

Margaret (Meg) Culpepper suffers from a rare autoimmune disease which leaves her in constant pain . She has pulled away from nearly everyone in her life, and has a rocky relationship with her mother. She enters a drug trial hoping to rebuild her immune system and lead a semi-normal life. Upon entering the hospital, it’s clear not everything is as it seems.

As someone who currently deals with a myriad of auto immune issues, pain, medicinal side effects, etc. I really appreciated how throughly the trauma of living in a body that feels like your enemy and the mental anguish that comes along with that is portrayed. Illness and pain can make you feel like you are going mad and you become an unrecognizable version of yourself. Starling really encapsulates the fear, exhaustion, paranoia, and mental deterioration that occurs from pain, hospitalizations, fear, and isolation.
I was never fully confident of what was real and was entirely enthralled by the story. If you enjoy medical dramas, cosmic horror, and open to interpretation stories, this is for you!

A story of desperation to heal from a rare autoimmune disease leads Margaret to sign up for an experimental medical trial. Mind bending. Daydreamy. This book pulled me in immediately and I felt every ounce of uneasiness and paranoia our main character experiences. This caused a sinking feeling I wasn’t aware a book could give me and I devoured every second. A true page turner for me.

Haunting, gothic, and oh so beautiful. This is an expertly created narrative that deals with the horror of women and the likes. A great one.

What happens when you find yourself in a drug trial that spirals into chaos? That’s the dilemma our main character faces in this thrilling body horror nightmare! Our main character, Margaret, checks into the clinic for treatment, hoping for a cure to her disease that causes much pain and discomfort, but what begins with high hopes quickly descends into madness. Can she trust her own perceptions as everything around her unravels? This book had me questioning my sanity! It was such an incredible, surreal experience that I ate it up in just one day. Look forward to checking out more from this author and a big thanks to NetGalley for providing my digital review copy!

I thought Starling did a great job of creating this unreliable narration where you never truly know what is going on. As someone with an autoimmune disease, I thought this book was especially horrifying and an interesting take on the pharmaceutical industry. I really enjoyed this weird, creepy, unsettling little book. Starling absolutely nailed the ending, but I did think the middle dragged a bit for me. Overall, I gave this book 4/5 stars and I look forward to reading more from this author in the future.

Wow! This was such a good read, a bit unsettling but once I started, I couldn't put it down. Thanks to Netgalley for the opportunity to read this book

My mind is spinning! I loved the lockdown-in-hospital/asylum concept—it always gives me that suffocating, walls-closing-in sensation, making every moment more intense until you can’t hold back your screams! And trust me, I screamed. I screamed while flipping through the pages, unable to stop, completely consumed by this masterfully unsettling story. I'm already a devoted fan of the author, but this book? This book pushed me over the edge! It was mind-blowing, deeply unsettling, and so immersive that I felt physically tense while reading. My body is still recovering from the sheer adrenaline rush!

Margaret’s journey through this experimental medical trial is a slow-burning descent into paranoia, where reality twists and shifts like a fever dream. The sterile, cold walls of Graceview Memorial hide secrets that claw at the edges of her sanity, and as she grapples with her own failing body, the terror lurking within the hospital tightens its grip. The sense of isolation is suffocating, and the creeping dread only intensifies with each new revelation. The medical aspects feel disturbingly real, making Margaret’s suffering all the more visceral. You can feel every ache, every fevered hallucination, every pulse of uncertainty as she tries to hold on to what’s left of herself.

What makes this story truly terrifying is how it burrows under your skin—not just with body horror, but with its exploration of medical ethics, power imbalances, and the psychological torment of feeling trapped, both physically and mentally. The claustrophobic atmosphere, unreliable narration, and a cast of characters who may or may not have sinister motives make for a nerve-wracking, mind-bending read. Just when I thought I had a grasp on what was happening, the story twisted in another direction, keeping me on edge until the very end.

This is not just a story—it’s an experience. A pulse-pounding, mind-warping ride that lingers long after you’ve turned the last page. If you love atmospheric, intelligent horror that messes with your perception and keeps you guessing, do not miss this one!

Huge thanks to NetGalley and St. Martin’s Press for the digital reviewer copy of this gripping gothic/psychological thriller in exchange for my honest thoughts!

𝐓𝐢𝐭𝐥𝐞: The Graceview Patient by Caitlin Starling
𝐆𝐞𝐧𝐫𝐞: Horror
𝐏𝐮𝐛 𝐃𝐚𝐭𝐞: October 14, 2025

✨️ Misery x Invasion of the Body Snatchers
✨️ Experimental Medical Trial
✨️ Medication-Induced Delusion

Having a similar autoimmune disorder, I was excited to The Graceview Patient because I felt I could resonate with Meg's character and it would make it more immersive. The pacing is a bit slow, especially in the beginning. There is a lot of "filler" in the form of treatment plans and medical lingo, but it picks up later in the book as Meg begins to question reality and quickly spirals into despair and (possibly) insanity. The twist was done well, I just wish I hadn't been left wanting more.

If you're looking for a slow burn medical horror then you should consider adding The Graceview Patient to your TBR!

Thank you so much St. Martin's Press and NetGalley for the digital review copy!