Blood Sugar

By Sascha Rothchild

A New York Times Best Thriller of the Year

"A fascinating story, wicked sharp writing, and an unforgettable narrator." —Samantha Downing, author of My Lovely Wife

She's accused of four murders. She's only guilty of three.


"I could just kill you right now!" It’s something we’ve all thought at one time or another. But Ruby has actually acted on it. Three times, to be exact.

Though she may be a murderer, Ruby is not a sociopath. She is an animal-loving therapist with a husband, Jason, whom she adored. But detectives at Miami Beach Police Department are eager to uncover why so many people have died within her arm's reach.

When we meet Ruby, she is in a police interrogation room, accused of Jason's murder—the one murder she did not commit. As she undergoes questioning, her mind races back to all the details of her life that led her to this moment, and to the three dead bodies in her wake. Because while she may not have killed her husband, Ruby certainly isn't innocent.

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Published Apr 11, 2023

336 pages

Average rating: 7.4

68 RATINGS

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Community Reviews

David Kyrisch
Jun 25, 2025
8/10 stars
Great book!

This book begins with a bang. In fact, we are introduced to Ruby in one of the most shocking introductions I have read in a long time. Totally brutal and we meet Ruby: A serial killer. Or is she? When you think of serial killers you think of someone with no empathy who creeps and kills with no remorse. Ruby is the exact opposite.... She loves her family (sister), her husband, and has a genuine love for animals. We see Ruby get emotional over a dead bird early in the book and in her own dog. She loves them so much I can see the author Sascha Rothchild have a love for animals as well as it comes along well in the book.

It's just every so often when she wished: "I wish you were dead!" She acts on it.

And thats where we begin in a interrogation room accused of the death of her husband. But that is the one murder she is not guilty of and we have a back and forth between present / past time as she tries to defend herself from the murder of her husband (who she loved) and her life growing up as a serial killer.

About the book.... Its very unusual in that is has the least amount of dialogue of any book I have ever read. In fact, when you read it it's almost like it's autobiography of Ruby herself: Written by her. For example, there is a whole section of her on a date and there is no dialogue for pages. It's just her thoughts on the whole thing. This makes the book read very slow but Sascha Rothchild is such a good writer that you are still hooked.

Just a few negatives that I have to address that prevent me from giving five stars is as mentioned the lack of dialogue. While not a big deal but when there is actual dialogue it comes across as cheesy in the beginning. Especially during her date mentioned above. This does improve in the second half of the book. Another weird aspect is her relation with her sister. In fact, it's because of her relation with her that she acts on one of her kills. But then she doesn't ever talk to her in 90% of the book. That just seemed awkward.

But still this book is highly recommended. We grow to feel for Ruby and overall the book is very entertaining. And she nails the ending and we have a great twist in the end that I never saw coming. Its a unusual twist but loved it! The book concludes very well but there does seem to seem like a small chance we can see more of Ruby in the future.

Highly recommended!

Book was given free for a honest review.
Michalmarie123
Apr 12, 2025
Melissa Becca
Barbara ~
Dec 11, 2024
8/10 stars
Is she a vigilante? Did karma finally catch up with her?

Ruby has killed before. Her first one was at the age of 5. Ten years later, she was about to get sexually assaulted so she killed again. The next one was about another ten years later and this time, she did give it some thought. But now, she is being accused of murdering her husband, Jason.

Did she commit such a heinous act? Jason’s mother and Detective Jackson seem to think so. Soon, her entire past and present life collide in the worst combustible way and Ruby’s life will never be the same again. She won’t know who are her allies and who are her friends.

I gave it a 3 ½ stars because it was a bit far-fetched but I must confess, I do like Ruby. She is a likable character, even if she is a bit aloof and OCD. I do love how the author’s debut thriller slowly builds up to her life spiraling out into chaos, yet all the while, Ruby is still caring and trying to help her patient, Gabrielle. Chapters 49 and 52 had me in the best possible way.

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