I first read this book when it came out, and I thought at the time that it was remarkable. Now, thirty years later, and with two sons in their early twenties, I find it much more painful to read (but because of that, even more remarkable). Barker frankly sneaks up on you a little bit…it all starts very genteel, with a rural hospital and convalescent patients, but the horror unfolds eventually…and as that happens, the best part of Barker's writing is her patience with, and empathy for, Rivers' patients (and him as well).Really a great book.