Set in 1964 New England in the cold of winter, Eileen as an older adult narrates a disturbing tale of her younger self, aged 24, focusing on the last week of her time in her hometown, which she snarkly calls X-ville. Eileen lives with her alcoholic and verbally abusive father and works as a secretary at a prison for boys. Unhappy with her life, her body, and her identity, Eileen desperately wants to escape to New York. This desire gets muted somewhat when Rebecca, a beautiful and well-educated woman who connects with Eileen, arrives as a new employee at the prison. The plot builds up to Christmas Eve, when Eileen, expecting a delightful evening with Rebecca, finds herself in a situation where the only way out she can see is to commit a crime. Moshfegh spends some time explaining the details of Eileen’s life, which helps highlight her difficulties and creates a dark mood in the narrative. While the suspenseful turn in the narrative takes some time to develop, it is a turn that is unexpected and carefully crafted.

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