The story is told mostly through the perspective of an odious and most likely paranoid schizophrenic called Horridge. This entirely unpleasant man is hate-filled, self-aggrandising, homophobic and racist. He even has a limp and at times feels almost a Dickensian caricature. But the book doesn't let the reader off that easily. We are trapped in the mire of Horridge's psyche and even when we escape for brief respites we see echoes of similar paranoia in the fear or drug-heightened senses of others.
After reading Campbell's moving introduction it is unsurprising that the author has such a drive to explore various expressions of paranoia, looking in turn at how it can cripple or aid us. A powerful read, but not a pleasant one.