Content Warning: Depictions of death by suicide, mental health disorders, and insensitive language toward transgender people are prominent in the novel. The novel also features hallucinatory characters that include a person with a congenital disorder and stereotypically racist versions of blackface minstrels. There are blunt and coded references to possible incest.

The novel begins with a prologue in which a hunter comes across the body of a deceased woman hanging in a tree. The hunter discovers near the body a gold chain that has a key and a ring on it. The hunter also notices that the deceased woman has a red sash on, which ensured that her body would be discovered.

Chapter 1 begins with an unnamed female character, who readers later learn is Alicia Western, having a discussion with another character whose name is the Thalidomide Kid. The Kid and Alicia appear to know each other, as their conversation reveals that The Kid has intimate knowledge of what Alicia thinks. Alicia is a patient at a psychiatric hospital, and her conversation with The Kid reveals that she is considering ending her life. The Kid is a somewhat comic and very coarse character, and he tries to lighten the