Thank you to Dutton Books for Young Readers via NetGalley for the free eARC in exchange for an honest review.

I am torn with my opinion on this book.

It's clear not only from the author's note but by the visceral descriptions of the MC's medical trauma that this is a story that is personal to her. The powerlessness and isolation (even when surrounded by people) that Justine experienced was heartbreaking and all too believable for anyone who has experience with the healthcare system failing them. I am glad that this book exists for purpose of representation because I have not read anything like it.

The first 40% or so of the book was strong, in my opinion. I was drawn in quickly and appreciated the looming dread of Justine's past against the stark contrast of Elizabeth's minimalist presence. However, I felt that the book was almost set up as a thriller, by the tone and timing of the beginning of the book. I kept waiting to find out a climactic horror that never occurred in the finale. It's not that Justine needed any more horror, her experience was certainly awful enough, the text was just pointing towards a climax that never occurred. I think that if the framing of the story were adjusted, the reader wouldn't be left feeling like they were led to nothing. 

I also wish we had learned more about Kacey, who was clearly an important presence in Justine's life, but who we never really dug into as a person or even in her relationship with Justine. Justine's mother, too, reads as two-dimensional, which can certainly be partially attributed to the POVs being from an eleven and eighteen year old. Noah and their budding relationship fell flat for me as well. Was he a safe haven (while pushing her boundaries) or a risqué choice (while again nothing really happened)? 

All in all I wish that this story were structured differently for Justine's story of horror to truly shine.