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Reviewers widely praise this book as an exceptional and brilliantly written crime novel, often calling it one of the best in the genre and a highlight of the Kenzie and Gennaro series. Readers consistently commend Dennis Lehane's masterful plotting, compelling storytelling, and razor-sharp dialogue. The author's strength in character development is frequently highlighted, with many feeling a deep connection to the protagonists, Patrick and Angie, and appreciating their realistic portrayal and evolving relationship. The novel is noted for its immersive Boston setting and its ability to deliver surprising twists and turns that keep readers engrossed from start to finish, leaving a lasting emotional impact.

Despite its critical acclaim, the book is described as an intensely dark and profoundly disturbing read. Many reviewers experienced significant emotional distress, even describing feelings akin to post-traumatic stress, due to the bleak themes and graphic depictions of child neglect and abuse. The narrative's relentless despair and lack of reprieve left some readers feeling numb, shaken, and deeply saddened for days after finishing. A few critics also found the initial pace slow or felt that the signature wit and sharpness of the main characters were less prominent in the first half. The ending, while courageous and thought-provoking, is almost universally described as painful and devoid of a happy resolution, challenging readers' sense of right and wrong.

Overall, this book is considered a powerful and important work that expertly tackles complex moral and ethical dilemmas, forcing readers to question their perceptions of justice and difficult choices. It is highly recommended for those who appreciate gritty, emotionally intense noir fiction and are prepared for a challenging and often heartbreaking experience. However, readers sensitive to themes of child abuse or those seeking a lighter, more conventional mystery should approach with caution. It stands as a significant entry in its series, often compared favorably to the author's other acclaimed works, and its successful film adaptation is also frequently mentioned.