This book is dark. It is incredibly difficult. And it is incredibly well-crafted. Yanagihara's prose is unlike anyone else's, and the moral ambiguity and unreliability of the narrator makes for an amazingly challenging read. I rate it five stars not because I "enjoyed" the story - because it truly is horrifying - but because this is a massive literary feat. It is a fascinating take on colonialism, the problem with scientific advancement at the cost of something else, and cultural relations. This book will challenge you, but it is well worth it.