This is a messed up book. It's also odd, imaginative, a little gimmick-y, gross, captivating, fascinating, horrifying, and weird. Set in the mid-1700s, our narrator is Tristan Hart, a young man of some means and some madness. Growing up with a depressed widower father, Tristan's best friend was the ethereal Nathaniel Ravenscroft, a handsome and daring young man who eventually runs off with gypsies. Tristan grows up a rather ordinary boy until an incident with a tutor brands him high-strung and prone to nerves. It is only his father's friend, novelist and magistrate Henry Fielding, who prises Tristan from the country and into medical school in London. There, Tristan learns he is gifted at the art and science of surgery and that his sole sexual pleasure comes from provoking pain.That's just the first half of the novel; the other half is Tristan learning to live with himself, his bouts of 'illness' and brushes with the supernatural, his love affair with a young teenager who matches his hunger for pain, and his passion for medical research. The novel is written in an archiac homage to 18th century literature, with all nouns and some adjectives capitalized, and unusual spelling. Although I started to grow accustomed to Wolf's archaic writing style, I also found it slightly obfuscated the action, especially the moments when Tristan was going mad/experiencing something supernatural. I'm undecided if this purposefully overwrought manner is awesome or too much of a gimmick. Here's a sample:I bade my Father's Gamekeeper bring me live Subjects for Experimentation and Study, and within a Fortnight of my Return my Cages had begun to fill, and my Laboratory to rustle. Yet, despite my stated Design, I found My Self incapable of performing a Dissection upon any of these, for the mere Effort of preparing Board and Instruments seemed beyond me. (p311)This book is gruesome and at times, was almost too disturbing (for me) to read. Wolf -- through Tristan -- lingers over his experiments in pain, his fantasies, which are not my speed and I found this book distressing at moments -- and suuuuuuuuuuuper addictive. While reading, I was reminded of Patrick Süskind's Perfume: The Story of a Murderer, Bret Easton Ellis if he adopted 18th century literary stylings, and the film Secretary. I'm totally undecided about how I ultimately feel having finished this novel. If you like dark, evocative, brilliant, chilling, creepy, overwrought, twisted and wicked fun, some literary gymnastics, historicals that feel historical, and very unreliable narrators, this is your book.