A gripping prose. Since it's first person narrative and a stream-of-consciousness style, you get to only know what Elena knows (badum tss) so it's very good at creating empathy with the character and the situation without ever letting Elena be defined by the illness alone. There's social commentary (or rather a full on thesis) on body autonomy and it's so layered that I didn't quite realize where it was going until the very end when everything falls into place. Truly an Oh moment.