Caitlin Starling’s The Graceview Patient is a slow descent into medical and psychological madness, where the line between reality and fever dream blurs in unsettling ways.

At the end of her rope, Margaret Culpepper voluntarily enrolls in an all-expense-paid clinical trial, hoping for a cure to her rare autoimmune disorder and a chance to reclaim her life. Over time, she has distanced herself from family and friends, whether by her own actions or their slow withdrawal from her life. The trial offers a radical solution: completely dismantling her immune system and rebuilding it from scratch. But as Margaret’s health declines and the treatment intensifies, reality itself seems to warp around her. Are her terrifying visions simply drug-induced hallucinations, or is something more sinister lurking within the hospital’s walls?

One of the standout aspects of this book is Caitlin Starling’s meticulous attention to medical detail. The accuracy of the procedures, lab work, and even the daily rhythms of hospital life add a chilling realism to Margaret’s ordeal. The patient’s perspective—isolated in both body and mind—makes for a haunting read, especially for fans of psychological horror. (This book contains both psychological and body horror.)

However, I found the pacing slower than I’d hoped. The buildup to the more intense moments felt drawn out, and while the psychological horror was compelling, I wished it had expanded into something more tangible. Without giving away spoilers, the ending left me feeling unsatisfied, offering more questions than answers.

While The Graceview Patient wasn’t a personal favorite, readers who enjoy a slow-burning descent into madness might find it intriguing. Just be prepared to embrace the ambiguity and let the unease linger long after the final page.

I received an ARC of this book. Opinions expressed in this review are completely my own.