I've read the entire book in which this novel is a part(It's a short story collection, with a twist). It is the most disturbing of them all, the other ones are also imaginative but more about human evil than sheer gut-wrenching. In fact, the author claims that this story has made over 70 people faint in readings all over the world, several times when he was reading it himself. The initial reaction is nervous laughter, then silence and cold sweat, and then every now and then a loud thump as someone passes out.
He's a great author though, but you need to be very open-minded to enjoy his books.
