Update, 6/19/17: 
 4.5 stars rounded down to four. 
 This seems to be a love or hate volume for Dark Tower fans. I have one friend who thinks this is the best book in the series. I have another who thinks it's one of King's worst in his entire bibliography. I'm in the lover category myself, but I understand where the haters are coming from. The action for the bigger story comes to a screeching, dead stop about 100 pages into this one, and the first 100 pages really belong at the end of The Waste Lands anyway. But I can't help it; I love the story from Roland's youth that makes up the bulk of this book even if it has almost nothing to do with the rest of his quest for the Tower. The last 100 or so pages puts us back into the main story, but it's kind of nonsensical. I like the Wizard of Oz touch... I guess, but it's not King's best work, feels slightly out of place, and a little forced, and therefore prevents this from being a five star book. 
 There's a heavy romance focus in this one as well, and romance ain't my cup of tea. Some friends tell me King can't write romance for shit, but I really wouldn't know since I have nothing to compare it to. Romance isn't the driving force in this, it's just tied in with the rest of the story, so it wasn't off-putting for me. I can deal with romance as a plot element to something bigger just fine, even if it's ladled in rather thick. It's when the story is all about the romance that I want to gag myself with a spoon. 
 King can also repulse me and make me laugh all at the same time, and that's quite a talent. (view spoiler)[Susan is to be Mayor Hart Thorin's gilly, a woman who is there to bear a child for a man whose wife is unable to provide such a service. He's not allowed to have relations with her until the fall due to superstitions, and Susan is just fine with that since she's 16 and he's a dirty old man. There are several months between the time Susan is okayed to be the gilly and the fall, but Hart can't wait. He keeps coming up behind Susan to feel her up and rut on her butt until they can consummate the arrangement for real. The first time this happens she tries to talk him out of it, but he ain't having it and says "I must have something, a bonbon, aye, so I must." As disgusting as the whole scene is, and as much as I would loved to have seen someone come up and put a bullet in Hart's head, I had to laugh out loud at him saying he needed a "bonbon" to tide him over until the main course. (hide spoiler)] 
 Another thing this story has going for it is that the town, and the Big Coffin Hunters in particular, frequently reminded me of Clint Eastwood's High Plains Drifter which is my all-time favorite western. I often wondered if Stephen King was inspired by that movie when putting this together as there are a lot of similarities, but nothing so overt as to make it a rip off; just little things here and there. (view spoiler)[A covered up murder, the whole town being in on some shenanigans against its government, three bad guys with free rein over the town, and that's just for starters. (hide spoiler)] We don't hear anymore about Hambry after the events in this tale, but I would love it if (view spoiler)[Susan's ghost (hide spoiler)] came back, cleaned their clocks, and burned the whole town down. 
 One other thing to note: This book has one of my favorite villains not only in the Dark Tower series, but in all of King's writings. Rhea of the Coos kills me. She is one of the meanest, most hateful, spiteful, vindictive bitches I've ever read about, and I love a good baddie. (view spoiler)[Roland kills her pet snake when it attacks him. In return, she causes the town to roast the love of his life alive, and later tricks him into shooting his own mother to death. After he realizes what he's done, she cackles "Do ye repent of killing my snake yet, gunslinger? My poor, sweet Ermot? Do ye regret playing yer hard games with one more trig than ye'll ever be in yer miserable life?" (hide spoiler)] HardCORE! 
 Also, I highly recommend the audio version of this read by Frank Muller. He gives the characters such depth. 
 Original review, 8/12/10: 
 Since the last book ended with a cliffhanger ending, they have to wrap that up before getting to the real story for the fourth installment of The Dark Tower. Once that's done, we find ourselves in... THE WORLD OF THE STAND. It's actually quite awesome that they just end up there. I always like seeing connections between books. Anyway, they pause there for a while and Roland tells his Ka-tet a story of his youth. The story has very little to do with the rest of the series, and takes up at least 3/4 of the book, but it's still a great story. 
 I love the scene of the almost-but-not-quite shoot-out at the bar, and it's preambled with classic King foreshadowing: "They talked about it in Hambry for years to come; three decades after the fall of Gilead and the end of the Affiliation, they were still talking. By that time there were better than five hundred old gaffers (and a few old gammers) claiming that they were drinking a beer in the Rest that night, and saw it all." It's one of my favorite scenes in the series, and maybe one of my favorite scenes in all of King's writings. 
 I guess you could read just pages 113-613 and have a great story in and of itself, because they can be read without giving thought to the rest of the series. However, the reverse is not true. Some things are discussed in that story that have a strong bearing on the rest, and you'd be lost if you skipped it.