If I hadn't read Koontz before, I don't think that I could have made it through this book. The title describes it quite well. But this is also the most disturbing villain in a Koontz novel I've encountered yet. The absolute evil that exudes from him is horrifying and I found I could only read in small bursts until the last section. Then I was speeding through it, heart racing, needing to know how it ends. It is graphically not graphic - it describes a lot of horrifying things including murder, sexual assault, rape, mutilation, torture - but Vess approaches things in such a removed almost clinical fashion that it isn't graphic yet somehow worse? Definitely a lot of triggers for people from Chyna's childhood and history to the things that take place in the novel to the things that Vess talks about in his past.
The thing that I continue to feel that sets Koontz's books apart is that even in the midst of these horrific situations, there is always a thread of hope and the power in human connection and community. It gets pretty thin in this book but it is there. I would not read this book again and I'm not even 100% sure I'm glad I read it but I'm not mad I read it either. It's very intense and not something to be read lightly.