Pepper gets in a fight with a couple of cops, and finds himself suddenly committed to a mental institution. The fact the he is not mentally ill doesn't seem to matter, and he begins doubting his own sanity when on the first night, he is attacked by a horrifying and vicious creature with the body of an old man and the head of a bull.

It might be considered horror, or suspense, but it is less a genre novel than a commentary on society's treatment of those on the bottom.

When the economy tanks and everyone is worse off, people in mental institutions and residential care have the least power over their lives and little recourse to poor treatment. Society allows them to be sacrificed, like offerings to the minotaur of the recession.

The shifts in tone and story focus can be a little confusing. Sometimes it's like the book is trying to tell too many very different tales at once.