This is grim stuff. The writing, which chronicles the extreme poverty, twisted religiosity, disease, violence, and sexual depravity of a "holler" in rural West Virginia (with periodic detours to Ohio and assorted rundown motels in the Midwest and South), is vivid and immersive. The downtrodden and/or despicable characters who populate this world live relentlessly bleak lives. Those that try to live decently are ground down by the harshness of their surroundings. Many succumb to their darker impulses to drink and drug and indiscriminately abuse those around them. A ghoulish pair of serial killers lurk in the background, eager to pounce on hapless hitchhikers. 
 Pollock does such a good job selling the grime I wanted a shower as soon as I finished this. This works if you're looking for horror, a pitch black coming of age story, or a snapshot of mid-20th century rural decay.