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!

Weirdly odd in the best possible way! To me, Caitlin Starling's writing has a quiet spookiness feel to it. I just love it. This book had it all: darkness, spooky and weird! I love it!

A very intriguing horror focused on a rare autoimmune condition - Meg qualifies and finds immense relief. Her illness becomes someone else's problem - she just needs to survive.
An excellent look at hospital care giving, ancient and outdated facilities. And of course - where do all the germs come from?

This plot is a tailspin to the imagination. Margaret faces a huge decision. Should she submit herself to a new experimental trial which may or may not cure her condition? The institution sets a cold setting to this story with intriguing characters around Margaret. Great story.

Review of Uncorrected Digital Galley

Margaret Culpepper suffers from Fayette-Gehret, a rare, uncurable autoimmune disorder that has virtually destroyed her life. But there’s finally some hope: she’s been invited to take part in an experimental medical trial that might be a cure. It involves an extended stay at Graceview Memorial Hospital, but Meg is desperate, and she enrolls.

As she undergoes the treatment and her health, as expected, begins to decline, she senses something strange in the hospital. Is it a hallucination? Or is it really a presence?

=========

In this mix of medical drama and science fiction/horror, readers are thrown into Meg’s confusion and paranoia, leaving everyone to guess at what is real and what is imagined. The plot is captivating, the situation at the hospital, chilling.

Readers who enjoy medical tales and those who enjoy a bit of horror tossed into the telling of the tale are sure to enjoy this cringe-worthy story.

Recommended.

I received a free copy of this eBook from St. Martin’s Press and NetGalley
#TheGraceviewPatient #NetGalley

4.5 stars, rounded up.

This book definitely brought the horrors of having chronic pain to life, along with a medical system that never seems quite able (or willing) to help. It’s also a complete fever dream at times, and it becomes impossible to know what’s really going on. If you’re okay letting go and allowing all the wildness to happen, you’ll be in for a really good read.

One thing, though—it looks like the syndrome the author used isn’t real? I couldn’t find anything about it online.

Thank you to NetGalley and the publisher for providing an ARC. This review contains my honest, unbiased opinion.