Review by Booklist Review
Owing to a rare autoimmune disease, Margaret "Meg" Culpepper had been unable to work regularly when she received an offer to participate in a paid medical trial. Over the course of a long hospital stay, her immune system would be eradicated and built back up. The possibility of restored health is irresistible, but once she checks in, she's afraid she made the wrong choice. The medication causes her to hallucinate and lose time. Large portions of her medical records are redacted, she doesn't know whom to trust, and she senses a sinister presence in the hospital. But is it real? Readers may wonder if the detailed documenting of Meg's infusions and procedures is perhaps unnecessary, but the repetition will produce the same effect on them that it does on Meg: uncertainty about what treatments she's undergoing and how much of their memory they can trust. Meg's increasing paranoia and unreliable narration contribute to a creeping, claustrophobic terror that will appeal to readers who enjoyed Victor LaValle's The Devil in Silver (2012), S.L. Grey's The Ward (2012), or Matt Shaw's Immortal Shadows (2021).
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
A hospital patient grows increasingly suspicious that the motives of her caretakers are far from benevolent in this suspenseful tale of medical horror from Starling (The Starving Saints). Twenty-six-year-old Meg Culpepper, who has a debilitating autoimmune disorder called Fayette-Gehret syndrome, agrees to a pharmaceutical company's offer of an all-expenses-paid experimental treatment dubbed SWAIL that promises to "rebuild" her "confused immune system." Isolated in a special ward at the hospital, Meg acquiesces to a protocol of restrictions and medicinal infusions that puzzle her but raise no alarms--until she discovers that the death of a fellow patient in the same treatment program has been kept from her by hospital personnel. Meg's frustration at her bewildering circumstances quickly curdles into the paranoid suspicion that she is being held prisoner by sinister forces with malevolent intentions. Starling expertly immerses the reader in Meg's anxiety, showing how even the most routine experiences during a hospital stay become cause for concern to her unsettled mind. The novel's horrors are all the more palpable for tapping into the squeamishness that many feel toward medical care. Readers are sure to be frightened. (Oct.)
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Review by Library Journal Review
Margaret Culpepper has a rare, incurable autoimmune disorder that has isolated her from her friends and family and is close to costing her her job. When she is offered a paid spot in an experimental medical trial at Graceview Memorial, Margaret jumps at the chance for a better life. She'll stay in the hospital for several months while her immune system is almost completely destroyed and then rebuilt. Once the treatment begins, though, Margaret begins to suspect that she isn't there for a cure. Instead, she seems to be a test subject for something far more sinister. Graceview's patients either emerge as entirely new people or die trying. Struggling to determine what is real, Margaret fights to find a way out before it's too late. The unreliable narrator, questionable medical practices, and eerie atmosphere combine for an intricate, well-written story. VERDICT Starling's (The Starving Saints) newest novel is the kind of genre-bending tour de force that fans have come to expect from her. Equal parts medical drama, psychological thriller, and gothic horror, the book pulls readers in and refuses to let them go.--Elisabeth Clark
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