Victor Mancini has a few issues. One, he's a sex addict, and a regular attendee at a twelve-step programme to try to combat his addiction, though his commitment to the cause is occasionally compromised by anonymous quickies in the toilets with fellow attendees. Second, his mother is in hospital with a terminal illness and he has to find the money for her medical bills, which he does in a combination of ways - through the more orthodox means of getting a job at a historical re-enactment theme park, but also through the slightly less orthodox means of faking a series of choking accidents at various restaurants and having members of the public "rescue" him by giving him the Heimlich manoeuvre; these "heroes", having now invested some emotional capital in Victor's welfare, can then be persuaded to hand over money later.
We learn a bit about Victor's past - taken into care at a fairly early age, he was passed around a series of foster parents and subject to a series of increasingly eccentric "rescues" by his mother, after which they would travel around together while she attempted to impart vital (and increasingly barking) wisdom to Victor before the authorities caught up with them again. Now his mother is in a seemingly terminal decline, and the only hope seems to be being offered by the foxy Dr. Paige Marshall, who has some treatment ideas that seem, well, unconventional to say the least. For instance, one of them involves Victor impregnating her on the altar in the hospital chapel, aborting the foetus and then using the genetically suitable stem cells thus acquired to do some sort of brain graft. Well, it might work.
So anyway, Victor's best buddy and fellow theme park employee Denny gets himself fired and then embarks on the sisyphean task of collecting up random bits of rock from around the city and cementing them into some giant structure (to remarkably little protest from whoever owns the bit of land they're doing it on), Denny and Victor become minor TV celebrities, Paige Marshall turns out not to be who she says she is, Victor's mother dies, Victor is arrested (in connection with her death) and then released and all ends - sort of - happily.
So we've all seen Fight Club, right? Well, that was Palahniuk's first novel - Choke was his fourth, published in 2001. It's highly reminiscent of the work of some other American authors of similar vintage - Douglas Coupland, Rick Moody, Dave Eggers - though it's probably less subtle and more gleefully transgressive than any of them. I'd also have to say it's probably not as good as, for instance, Moody's Purple America or Coupland's Miss Wyoming, both of which explore broadly similar subject matter (celebrity, relentless prescription drug use, joyless desultory sex, tortured parental relationships, general ennui). A bit like Platform, though, the relentless energy is all very bracing, though it's a bit too much like being poked in the eye to be completely pleasurable.
Choke was made into a film in 2008 starring the excellent Sam Rockwell among others - here's the trailer.
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