I started this collection of short stories right before bed. This was a bad idea. When I finally slid my kindle underneath the pillow on the other side of the bed where it regularly spends the night, my heart and mind were racing, fueled by anxiety. Would I ever sleep again? Why were these stories, works of fiction, so fucking real? Medical horror is not a genre you want to relate to, but here I was relating to the horrors I was reading.

The first story, Lifeline, takes place in a reality where the amount and level of medical treatment you are allotted is determined by your credit. I thought about that episode of Star Trek: Voyager where the Doctor is stolen and forced to treat patients in a hospital where their treatment is determined by social status. I thought about the hospital scene in Idiocracy when the doctor discovers that Joe doesn’t have his tattoo and freaks out. And I thought about every single person I know who puts off medical intervention until they just can’t anymore because even with insurance, it costs so much and without insurance? Forget about it. I mean just recently I put off getting my teeth fixed until I physically couldn’t anymore. This story is closer to reality than most would care to admit. This is everyone’s nightmare.

In fact a lot of stories in this collection are firmly rooted in reality. The next story, Autoimmune, describes a man with a strange condition that begins with a nagging itch and quickly progresses to the point where his skin is literally sloughing off. The medical advice is to use this cream he knows doesn’t work for the next two weeks and then they can try something else. Yet another relatable medical situation. My doctor is great, but I have friends and family who have had to deal with the suffer with this treatment you know doesn’t work for you before we can try something new approach to medicine. You know how hearing the words flea or lice makes you itch? This story is like that. I have thought about it every time I feel the beginning of an itch since I read it. I have psoriasis that went untreated for a long time due to reasons expressed earlier (see Lifeline), and I know that unrelenting burning itch well. Fortunately I only had to try two creams before finding one that works for me. But this story is my nightmare.

Now this is where my body betrayed me in favor of sleep and I just couldn’t finish the next story without my eyes slamming shut every few words. The story, Fat, follows a large woman who just can’t seem to drop the weight she so desperately needs to lose. She’s tried everything short of bariatric surgery and hasn’t been able to keep any weight off. Sound familiar? My fellow chonkadonks know that struggle. This woman decides to try an experimental weight loss treatment that has well documented deadly side effects. But she’s desperate and desperation can make a person take risks they normally wouldn’t. I fell asleep right after she started to experience results from the treatment and my mind conjured up all sorts of wild continuations of the story, none of which were how the story actually ended. Oh hey, this story is also my nightmare.

Speaking of side effects, the story “Side Effects Include”…you know those ads for prescription drugs that show happy people walking in parks while a voiceover rattles off a list of side effects that are worse than the condition the drugs are meant to manage? In the real world, most of us only ever experience minor side effects. But imagine if you’re that person who has all the worst side effects at once, so severe that they require medical intervention. I could go on and talk about every single story in this volume, but I think this is a good stopping point. This is my second read by Ruth Anna Evans (Cargo was the first) and it has solidified her as a must read author for me.

This is a ⭐️⭐️⭐️⭐️⭐️ read. Horror can sometimes be very surface level, aiming to frighten, shock, and disgust the reader without digging too deep into why it’s frightening, shocking, and disgusting. It often relies on causing visceral reactions rather than emotional ones. You’re not meant to relate to horror. And yet, sometime the most frightening stories are the ones to which we can relate. This is where Evans shines.

Big thanks to Ruth Anna Evans for providing an ARC in exchange for an honest review. You can preorder the kindle version OH FUCK OH FUCK IT HURTS: A Collection of Medical Horror, by Ruth Anna Evans on Amazon for a buck and read it on September 12 or buy the paperback right now for a couple bucks. Do it.