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.

This is a gothic, atmospheric, and claustrophobic novel set almost entirely in a hospital. The creepy vibes ooze from the pages as our protagonist is physically and mentally drained. But what's real and what's just in her head?

Meg has a rare autoimmune disease which makes her life miserable. When she gets accepted into a trial that might just cure her, and she'll get paid for doing so, she decides with trepidation to join.

There are some serious consequences though. She must live in a hospital during the trial, it's going to be extremely painful at times, and they're basically going to get rid of her immune system and then replace it.

As she succumbs to the treatment and the various drugs they pump into her system, horrific things begin happening. Hallucinations? Waking Nightmares? Or the product of the treatment? Or...is it all real and she's being used for something nefarious? All these possibilities intertwine as the story progresses and each new revelation, real or not, just ams up the dread.

And there are some creepy, frightening things going on. The doctors and nurses might not be truthful, people are getting sick and dying, and the hospital itself seems to be alive and breathing.

We experience all of this through Meg's eyes and perspective. This author does a great job of building suspense and unleashing it on terrifying sequences which are then doubted as if they never happened. You'll be on the edge of your seat all the way until the end to see what's real and what's not and it's a nightmarish claustrophobic ride I highly recommend.

Rating 3.75 Rounded up.

During this entire book you will be question reality. Are things truly happening or are they drug induced dreams or hallucinations? Even at the end I am still not sure what was real. I found it amazing that the author could create such in so atmospheric darkness while really never leaving the same scene. We are always in the same hospital on primarily the same floor and room. Yet so much darkness and mystery are created. The graphic descriptions are not overwhelming and are done tastefully. I personal enjoy a good body gore story so I would have liked more but I do understand why the author went this route. Over all well written and captivating story. I will bet some will not like the ending being there really isn’t one but I never mind an ending that leaves me questioning.

Gasp! This locked-room hospital horror was so intense, I found myself completely immersed—constantly questioning what was real and what wasn’t. When it finally ended, I could at last gasp for some much-needed air.

Margaret has suffered from an autoimmune disease her entire life. Over the past few years, it has progressively worsened, making it nearly impossible for her to hold down a job or leave the house—effectively destroying the life she once had.

She’s offered a fully funded spot in an experimental medical trial at Graceview Memorial. The procedure? Break down her immune system and rebuild it from scratch, in hopes of killing off the disease. Simple, right?

But as the treatment begins, Margaret starts experiencing strange occurrences—unexplainable noises in the night, missing staff members, and terrifying visions that blur the line between hallucination and reality. Her isolation in the sterile hospital room only amplifies the creeping dread, and the sense that something is very, very wrong at Graceview.

The writing masterfully balances body horror with emotional vulnerability, painting a chilling portrait of a woman at war with both her body and her mind.

This is more than a medical thriller or a horror novel—it’s a haunting exploration of illness, identity, and the terrifying things we’re willing to risk for a chance at being “normal.” I couldn’t put it down.

Thank you to NetGalley for this e-ARC in exchange for a review.
The Graceview Patient is a hospital horror that slowly builds dread and suspense through the perspective of a vulnerable patient who I found easy to empathize with. I felt like I was trapped in a fever dream with hospital walls closing in on me while reading. Starling utilized an excellent setting to immerse the reader in a claustrophobic, slow creeping horror. While the open ended opening might be a negative for some readers, I appreciated that the ending wasn’t in a neat little package as it assures me that I’ll be thinking about this book for a while.
Plot & pacing- the pacing was slow but effective and the plot appears straightforward at first but there’s more unexpected reveals towards the end. I found that the use of atmospheric dread made the plot engaging.
Writing- I’ve been a fan of Starling’s prose since I read the Death of Jane Lawrence. The writing style is well-suited for a horror novel that feels like a fever dream. It’s effective in creating an immersive experience.
Characters- the main character Margaret was the one I was most invested in. There were 2 other side characters I found intriguing as well but I probably won’t remember the names of all of the nurses in a couple of days.

Thank you to NetGalley and St. Martin's Press for sending me an eARC of this title in exchange for an honest review!

I recently read Starling's "The Starving Saints," so I had some idea of what I was getting myself into with this novel. That said, in no way could I have predicted what would take place within these pages. I'm absolutely OBSESSED with this novel and Starling's writing in general-- but that ending!!!! Ahhhhhhh I literally had to flip back and forth a few times on my Kindle to make sure that was actually the end of the book-- even going so far as to reload the ARC, just to double check. At first I was disappointed with the ending, and wanted more, but I've made peace now with the ambiguity and embraced it wholeheartedly. I loved this book, just as I loved "The Starving Saints," and I can't wait to read more of Starling's work!

The Graceview Patient by Kaitlyn Starling, when Margaret gets a call telling her there’s a patient study happening for her autoimmune disease she is hesitant at first but then learned she will be paid for the study and it may in the end cure her. on her first day there while getting settled in she meets the smoothie Adam who she doesn’t know is she dislikes or it’s attracted to him but he brings her to meet Veronica she also has Fayette Garrett’s disease and has been in the trial for a while. She looks emaciated and during her and Margaret’s conversation at one point she freaks out and asked Margaret if she heard that and when Margaret says no she tries to play it off as if it was nothing this only alerts Margaret to the fears she already has but no one will answer her questions and soon when the girl goes missing Margaret will do everything except follow the rules and in the end Veronica will not be the only person who leaves without explanation. She doesn’t know who she can trust nor what is real or fake she sees an apparition but again doesn’t know if she is really seeing someone or it is a phantom and when the book ends you’ll still be wondering that as well. I did find this book claustrophobic 100% creepy I just wish some of the questions would’ve been answered by the end I really wanted to love this book and as I said it was truly creepy well worded in a writing style I really liked until I got to the fever dreams and parts of the book that you didn’t know whether it was reality or her imagination. For example was Adam really as bad as he was portrayed? Who the hell knows cause I still don’t. I like the writing style so much I want to buy another book by the author but she’s another author who wants to send you electronic data that is way too costly I do not pay over $10 for a books and find $10 a lot and it makes me so frustrated when authors want to sell you a book that other authors sell for two dollars for $17 that is a lot for a JPEG. That’s neither here or there that is nothing to do with whether this book is good or not I mean I do recommend it if it sounds like something you would like I just didn’t like the ending the unanswered questions and the dubious finale. #NetGalley, #SaintMartin’sPress, #TheBlindReviewer, #CaitlinStarling, #TheGraceviewPatient,

Caitlin Starling could send me her grocery list to read and I’d love it.

If you like medical/body horror read this immediately- so many of the descriptions made me sick to my stomach in the best way. Lushly described in a wonderfully revolting way, plays with the gothic aspects so well. The “woman trapped in a haunted house” “is it real or just my mind/medication” translated so well to the hospital setting. Definitely similar vibes to Mexican Gothic, cannot wait to get a physical copy when it releases!

Thank you NetGalley and the publisher for this ARC.

3.5 stars

Medical thrillers are some of my favorites! I was so excited to get this ARC and read it in two sitting.

You could really feel it as her world began closing in around her, and how she was essentially forced to keep going. Healthcare and insurance is a nightmare on its own, but throw in forced isolation and body horror and it's tense and creepy!

I started off really enjoying this. It read almost like a journal. The main character is to spend a few months in a hospital as part of a clinical trial. The days go by, you learn and almost experience the pain, sickness and loneliness with her. As the story neared it's ending, it became weird, confusing and then it just ended.

Overall, I liked it but I felt it had so much more potential.

I have recently discovered that I love a hospital/asylum/locked ward story. This was the PERFECT read to satisfy my craving for another one of those! It was intense and eerie and unsettling. I was on the edge of my seat and very unwilling to read this after dark lol.

Actually finish this a few days ago and had to take some time to think about it before reviewing. I normally love Caitlin Starling, and she has done great work with unreliable narrators before. This one though, I think, may have needed some more time in the oven.

Don't get me wrong, it's a decent, if repetitive read -- but our protagonist Meg starts out so desperate and at the end of her rope, that the tension never really built for me. Her paranoia spirals out of control and either bad things are happening to her, or grip on reality is slipping... but the stakes never feel any higher. She can't leave the hospital because she's dying anyway, she starts desperate and.... continues to be desperate.

I get that we are left in the dark because Meg is left in the dark, and I see how that can be immersive, but it just made it harder for me to care. We don't understand the motivation of the people running the study, we don't learn enough about the hospital staff to discern their intentions, and we definitely don't have enough grounding moments to understand the infection?entity? thing.

I'm a big Starling fan generally, have read everything's she's put out and will continue to do so. This just doesn't even stand in the Shadow of "Last to Leave the Room" or "Luminous Dead"

Caitlin Starling is very skilled at writing engaging stories that take place in one main setting. Happening entirely in a hospital and mainly within one ward, The Graceview Patient still conveys an otherworldly atmosphere amongst the medical instruments and hospital procedures. I found myself quickly invested in the story, curious about Meg’s perception of reality and drawn into the interactions with other patients, nurses and the mysterious medical rep, Adam. Meg’s connection to nurse Isobel is a successful driving force behind the plot. Unfortunately I felt that the final quarter of the book did not hit as strongly as I would have expected. I think it made sense in terms of the progression of the plot, but I still felt like something was missing. I think a reread might clear some aspects up, but this book is similar to the Starving Saints in that rolling with the uncertainty and unreliable sense of reality is part of the experience. In the end, The Starving Saints hit a lot more strongly for me, but The Graceview Patient was a solid book and left me wanting to read more of Starling’s work.