This book was AMAZING. It was super unique and I loved every second of it! Truly a creepy and wonderful read.

•Margaret lives with a very rare autoimmune disorder. There is no cure, it has left her isolated & she has lost hope- until she is provided with the opportunity to be part of an experimental medical procedure at Graceview Hospital. With this treatment, she will lose practically all of her immune system & then rebuild it from the ground up. During her stay, things turn sinister, what is real and what is delusion?


I was so excited to receive this ARC because I love an asylum/lockdown suffocating story. I found this to be extremely unique, like nothing I’ve ever read before. I was totally intrigued the entire time and the build up was slow & consistent- but lead to nothing lol. The entire time I read this I was waiting for some huge reveal that never came. I can appreciate a cliffhanger in any horror story, I do feel that, when done correctly, it adds to the experience. This one had SO MUCH POTENTIAL, then missed the mark for me.

five stars. this may be one of my all time favorite books. the atmosphere, the hospital— ALL OF IT WAS SO AMAZING

Bleak, dark and claustrophobic. This certainly isn't an easy read - but then again, horror stories rarely are. I went in thinking I probably wasn't going to enjoy this so much as horror is not usually my cup of tea. I was, however, immediately sucked in. It didn't really get into the horror part of things until the last quarter of the book. Prior to that it was spending time inside the main character's head, which was NOT a pleasant place to be. She finds herself in a trial for testing a protocol for a new drug related to her condition, which is a pretty rare one. Basically, the drug they are using tears down her immune system before they build it back up with a defense for her condition. There are many things that are a red flag, and you want to yell at her to get out while she can. Instead you can only sit back, watch it play out, and see it all unravel.

First off, I would like to thank St. Martins Press and NetGalley for the Arc. Caitlin Starling has been on my radar for awhile now as her books sound like something I would really enjoy. For one reason or another there was a hold at the library, and I went with something else, but I was finally glad to get my hands on one and see for myself. Also to preface this review, I don't get too into the plot as you can read the description yourself and if you're just looking for a summary, please go somewhere else.
First off, I enjoyed this novel very much, I probably would have liked it more if I hadn't just read like two books before this with a questionable narrator. Another in a line of "is this woman crazy, or are the crazy things real?" I found the ending the be very ambiguous (and sudden), so it's up to the reader to decide.
I was engaged right away with the narrator and also terrified as being trapped and sick is a personal fear for me. Somewhere along the way things began to feel a little repetitive. Meg is injected with "medicine" feels bad, feels better, questions everything, paranoia, rinse and repeat.
All the characters felt real and flushed out, picturing everything that was happening was clear. I really liked Starling's writing style and will definitely be checking out more of her work.
I'm sure there could be essays written about body horror, not believing women when they're sick, or our horrible medical system, but I will leave that to people smarter than me. This is certainly worth your time, but if you hate not having a clean cut ending, you might want to stay away.

Thank you netgalley for an eARC in exchange for an honest review

3.5

I tore this book in a single night. An unreliable narrator with nothing to lose, and a chronic illness that took away her life, we meet Margaret(Meg). The story begins with a lack of options and nowhere to turn to. Meg is given an opportunity by her rheumatologist to undergo a trial that could change her life.

The body horror is amazingly uncomfortable, and the doubt that keeps passing through my mind as we are painfully aware that Meg might just be succumbing to the medication. The question remains, "Is what I see real?"

I don't want to explain any longer, as there is a disappointment towards the end from a lack of clarity. The end was too abrupt, and it left me questioning if the end was actually part of the book at all. It seemed like a setup for a second book, but we will see.

Medical gothic!

Margaret has a rare autoimmune disease. She decides to take part in a trial that will destroy her autoimmune system and then build it back up. To do this, she must be admitted to Grace view Hospital as a patient. But soon she is having a hard time making out what is real and what the medication is causing her to see...
I read this book in one sitting. It sucked me in and wouldn't let me go. I couldn't wait to find out what would happen next. Highly recommended.

Thanks to NetGalley for providing me with an advanced copy of this book in exchange for an unbiased review.

3.75 stars

I have to agree with other reader who have said “fever dream”
That’s the best way to describe this book. I love this unique idea of the experiment and autoimmune disease.
The writing was just wonderful as well!

3.5/5.

After absolutely LOVING The Starving Saints, I was eager to pick up another book of Starling's. As always, her prose was delectable and her use of body horror is always spot-on, and I loved how everything began to come together in the worst possible way near the end of the novel—and had us, as readers, questioning what was real and what was not right along with Meg. Being someone who has had some poor medical experiences too, I think Starling absolutely managed to nail the environment (absolutely stifling), the fear, and the feeling of isolation when you lose so much of yourself to being sick that it becomes your only choice to neglect the rest of your life to hold on to the scraps of sanity you have left. It's clear this book was written with a great deal of respect and compassion, without making caricature of real struggles for the sake of shock value, that I think is a pitfall that gothic novels can often experience and that often makes me tentative around the genre, even as it's one of my favorites. I'm not sure if medical horror is quite my preferred niche, but Starling was able to pull off and make real what is so often sensationalized and hollowed-out in media.

With that said, as I feel is shared with other reviewers, the ending felt abrupt and didn't seem to provide the closure that would have fully tied the conclusion of the novel together in the way I would have liked.

Thank you to St. Martin's Press & NetGalley for the ARC.

3.5 stars rounded up.
I really enjoyed this creepy book. I was drawn in immediately by the strange aspects of the hospital and the treatment that Meg receives. As someone with a rare autoimmune disease, I empathized with Meg and understood her choice to undergo such a horrible procedure to try and rid herself of her rare disease. I think this is more of a thriller than horror, and I was totally fine with that. If you are squeamish about hospital tests, this might not be the book for you, but I never felt it crossed into body horror or anything. Thank you to NetGalley and St.Martin's Press for this ARC.

5 plus for readers of physiatric/mental institutions/scenery. It is impossible to put down. The moment I got it, I started reading, and it's amazing nonstop horror, constantly doubting what is real or not. Amazing. A woman is desperate to be healed from her condition, so she joins a trial treatment, but the loss of control and despair is so well written with the perfect pacing that it gave me shortness of breath and other hypochondriac symptoms.
It's also relatable because so many of us reach out in despair to medicine for a solution to our problem, and then when we realize we made a mistake, we're too deep in it, we can no longer tell what is true, and there is no path back. When the character tells the nurse she has no family and no contact, I felt fear and thought... oh no... don't tell them that. Don't tell them that if you are gone, no one will look—so unsettling. 5 plus.


(Posted to goodreads, phone doesn't let me add the link have to do it from a desktop) will post to others closer to the month.

Thank you so much for the access to this one. Amazing.

We follow Marget Culpepper. A woman who is chronically ill and down to her last straw when she decides to participate in an inpatient medical trial for her extremely rare condition. As treatment continues and days and nights blur Margaret starts to question what is real, what is sickness, or malice. Will she survive her disease? Or was her disease never the force she had to survive to begin with?

This book was captivating. As a nurse I was astounded with how accurate medical tidbits were placed throughout the book and explained in a way anyone can understand. As a chronically ill girly (dysautonomia club!) this book had me SHOOK. It captured how exhausting and trying chronic illness is. How you just want to be better, feel better, but your body betrays you. Then when you think this may be working out and the treatment is working then your mind betrays you or does it?

10/10 Caitlin won a new fan with this book!

I received this book as an eARC. Thank you to the Author Caitlin Sterling and the publisher St. Martin’s Press. Thank you to Reedsy and NetGally

I read this in one sitting and could not put it down. I loved the claustrophobic atmosphere, the unreliable POV and the body horror. The hospital setting and medicine jargon (without overwhelming the reader) were described so well that I googled the name of the protagonist’s fictional illness to make sure this condition does not exist ;)
I’d give it 4.5 stars, would be 5 if the resolution was more satisfying. I know from „The Death of Jane Lawrence” that the author likes ambiguity (and I loved that book, which made me eager to read this one!) but I wish some things were more clear for the reader. I also think some characters could be further developed or nuanced, but I understand that we get a limited view of them through protagonist’s perspective.

I thank St. Martin’s Press and Netgalley for an ARC in exchange for honest review.

Thank you to netgalley for providing me with an ARC in exchange for my review.
The last book I read of Caitlin Starling‘s, I was not a fan. The death of Jane Lawrence fell short for me, so I was hesitant to try this one. I am so glad that I changed my mind. This was so good. The grace view patient is claustrophobic and horrifying and beautiful all at once. The journey that Meg goes through and her perception of events is so well written. I think this one might be best if you go in with less information. Just know that the Graceview patient is a remarkable medical nightmare and fever dream. I loved it.

We are so blessed with multiple Caitlin Starling books this year. I fell in love with her writing after reading The Death of Jane Lawrence a few years back, and when I saw she was writing a book promo-ed as a “hospital gothic”, I knew I had to read it; and wow, did it live up to my expectations. This book is wild, and so good. From the first page, it pulls the reader down the rabbit hole into a fever-dream of a story. This genuinely creepy gothic feels uncomfortably relevant in the 2020s, but that’s what good horror does: it makes us face and explore our current fears.

Margaret has an extremely rare immune disease that has all but ruined her life. When she gets an offer to participate in an experimental new treatment that would destroy her nonfunctional immune system, then rebuild it from scratch, she doesn’t think the process could be worse than the pain and difficulty she lives with day by day. Fueled by the hope of having a healthy body, she agrees to go through the treatment, and is checked into Graceview Hospital as a long-term patient. But the treatment is far more painful and grueling than she was led to believe, and as her body becomes weaker and her mind fights the haze of medicine constantly pumped into her, she begins to suspect there’s something sinister behind her treatment. Her care team assures her that the medicine is making her paranoid; but how can she know if they’re telling the truth? Reality and fiction blur as Margaret fights to discover what is happening at Graceview, and if she is a patient or a victim.

I do not scare easily, but this book made me deeply uncomfortable several times (in a good way); the story is claustrophobic and unnerving. As a reader, you feel as helpless as Margaret, forced to witness medicine slowly unravel her body and mind, while constantly unsure what is real. I mentioned this book feels uncomfortably relevant, and it is; we live in an era where medicine can feel hostile to patients. For many people, a serious diagnosis is automatically a sentence to debt or even bankruptcy. Even if you can afford treatment, there’s no guarantee you will get a doctor who will listen to you or take you seriously; gone are the days when we had family doctors we trusted, and Starling taps deep into that cultural stress and uses it as a foundation for a nerve-wracking story. Aside from the cultural commentary, this is an amazing gothic thriller; fast-paced and almost impossible to put down, it takes all the traditional tropes that define gothic books and puts them into an entirely new setting and story, and it works so well. If you are a fan of the gothic, you have to read this one; I loved this book, and will be buying myself a copy when it publishes!

I would recommend The Graceview Patient to fans of the gothic genre, body horror, and psychological thrillers.

Thank you to NetGalley & St. Martin’s Press for the arc! All thoughts & opinions in the review are my own.

This book was a dizzying fever dream, a narrative of a descent into madness and I loved every moment of it! I also now have more reason to fear hospitals lol

"The Graceview Patient" is my favorite Starling book in years; it's addictive, frightening, and filled with body horror. Following the tale of a chronically ill sufferer of a rare disease through an unorthodox treatment, the reader is never quite certain what is real and what isn't - a Starling specialty. While the real horror of this novel might just be the American healthcare system, I had to knock off one star because the ending just didn't quite work for me. However, this was a great chiller and I very much enjoyed it overall.

No notes, this is one of the best psychological thrillers I’ve read in 2025. I’m always looking for the next one that gives me the same vibes that gone girl did and this one delivered.

The painful isolation of the main characters illness and the questioning of what is real and what is a delusion - the perfect blend of thriller/horror.

Struggling with a rare autoimmune disease, Margaret (Meg) jumps at the opportunity for a spot in an experimental medical trial at Graceview Memorial. The procedure pushes her immune system to the brink—first destroying and then rebuilding it. But as the weeks go on and the treatments progress, Meg begins to sense that something isn’t right, especially as strange occurrences keep happening and she notices unsettling behavior in the other patients. Is she suffering from medical induced delusions from the trial or is something far more sinister happening within the hospital walls?

The synopsis immediately hooked me, and I knew right away that this was going to be a strange book. The hospital has a dark, gothic feel to it and I had a sense of dread that something awful was going to happen. This story handles the topic of chronic illness really well and Meg’s treatment and recovery journey was truly harrowing.

While there were aspects I enjoyed, the pacing really dragged and I found myself bored at times. I did enjoy the side characters, especially Isobel and Veronica, but the main character, Meg, felt one-dimensional. The central mystery was weird enough to keep me reading, mainly because I wanted to find out what was actually happening. Unfortunately, the ending left too many unanswered questions.

I really wanted to love this, but it just wasn’t for me. If you’re looking for a medical thriller that explores themes of isolation, distorted reality, and body horror, you may enjoy this more than me.

This is a fantastic live, slow-burn of a body horror. Starling's ability to unite characters without ever actually bringing them together is an aspect of her writing that I absolutely love. I want connections between characters but I don't want time wasted within story on the love story.

This feels like a gothic horror without being one so it doesn't feel stale. It's innovative and new with great, flawed characters.

I highly recommend!