If you can get past the ick factor, the story itself is captivating. With just a touch of fantasy (a really really slight touch), the author conveys so much with very little. She weaves words in such a way that you get what she is saying without her actually ever saying it. It makes for a fascinating read, but I did feel that something was lacking. 
 However, I liked that fact that it was slimmed down from your usual fantasy or romance. It only took about an hour and a half to read all the way through. I was in the mood for a novella, and this one really told a strong story in a short time. 
 I wouldn't recommend this for younger readers as the subject matter is somewhat disturbing. Don't expect a high fantasy setting with this one though. Like I said, the characters never actually confirm any sort of paranormal goings-on, they just hint at it. 
 I definitely would have liked more closure on the fantasy part of the story. I guess I would just like to know if my assumptions are correct. That's the difficult thing about how she chose to tell her tale, you are never really sure. I think maybe a prologue or an epilogue would have been just enough to tie it all together.