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If you do give Choke a chance, don’t feel bad if you find it revolting. Palahniuk challenges readers from the start: “If you’re going to read this, don’t bother. After a couple pages, you won’t want to be here. So forget it. Go away. Get out while you’re still in one piece. Save yourself.”

After this admonishment, Palahniuk launches into the story of Victor Mancini, a medical school dropout who works as an Irish indentured servant at Colonial Dunsboro, a living history farm that recreates America circa 1734. For $6 an hour, Victor gets to hang out with Denny, his best (and only) friend, a masturbation addict who keeps getting thrown into the town’s wooden stockade, the penalty whenever a re-enactor gets caught out of character. Denny’s plight keeps him ’sober,” and gives the tourists something to videotape ” and their kids someone to torment, like when one of them writes “Eat me” in bright red felt-tipped pen on Denny’s head when he’s bolted into the stocks.

Denny isn’t the only misfit in Victor’s life. Come to think of it, there isn’t one character in Choke who would be considered “normal.” Palahniuk is not interested in the kind of introspection one finds, say, in John Updike’s works. Palahniuk is the anti-Updike; his characters are all action, not at all interested in navel gazing. Unlike Updike’s relentless examination of suburban angst, Palahniuk dips deeper into the gene pool. His characters are often deplorable, even violent, in a sense, and more like the people most of us interact with on a day-to-day basis.

Palahniuk recently told Spin magazine, “I hate books where people contemplate things. And I don’t write them. I write books where things are always happening to up the ante.” The things that happen to Victor in Choke are told in alternating chapters that focus first on the childhood of the “icky little shit,” then on the grownup Victor who cares for his dying mother while struggling through his own messy life.

The young Victor bounces between foster parents when he’s not being kidnapped by his real mother — a rebellious woman with criminal tendencies. Mother/son have an elaborate code to signal each time she’s released from jail. So, when Victor is in a department store with his foster mother and hears an announcement over the intercom, “Would Dr. Paul Ward please meet your wife in the cosmetics department at Woolworth’s,” he knows his mother is waiting. The dutiful son always responds to these signals, even though he intuitively realizes that his mother is crazy.

The adult version of Victor — a medical student who drops out to care for his ailing mother while trolling support groups for sex addicts to get laid — is the natural outcome of such a life. Victor also spends a great deal of time and energy perfecting his second job: pretending to choke to death at restaurants. Victor rationalizes his behavior by explaining that the “heroes’ who ’save” him gain strength through their courage. “You might be the one good deed, the deathbed memory that justifies their whole existence,” he says.

In more practical terms, the heroes also become Victor’s benefactors. He milks them for spare cash, which they ultimately provide. Every night at the dining room table in his mom’s house, Victor records the day’s loot — checks, birthday cards and other gifts — which he uses to pay the $3,000-per-month cost of his mother’s stay at St. Anthony’s Care Center. “It’s all so easy,” Victor explains. “Just let yourself be broken and humiliated. Just your whole life, keep telling people, I’m sorry. I’m sorry. I’m sorry. I’m sorry. I’m sorry”“

There’s much more to Choke. I’ve barely scratched the surface, but along the way Palahniuk applies his brilliant brand of social satire to countless American institutions, including religion, elder care, self-help groups, the police, local television news, and psychiatry, to name a few. Choke should solidify Palahniuk’s standing as one of America’s hottest writers and extend his influence, especially since the movie rights were recently sold to producer Beau Flynn. The book will also challenge and inspire readers who now follow the author’s every step, based on the raw nerve he touched with Fight Club.

Choke is good. Choke is brutal. Choke is rewarding. Palahniuk has his finger on the pulse of people who are merely human fodder for the corporate bigwigs and soccer moms speeding along in their oversized SUVs, cell phones glued to their ears. Palahniuk’s characters are real people, just like in his masterpiece Fight Club, who keep this country glued together. They’re searching for some version of the American Dream, even if they know in the back of their minds that it is probably fruitless.

It’s a new era, but Palahniuk reminds me of the great authors of a century ago, writers like Theodore Dreiser and Frank Norris, who took it upon themselves to describe the gritty world around them — skid row, slums, and houses of prostitution — when it was fashionable to write about the upper classes and romanticized historical fiction. Palahniuk explains the story behind Choke on the book’s “official” Web site, put together by his publisher (which seems like a strange place for the author to comment, given his scathing views of consumerism). “I wanted to write about the moment when your addictions no longer hide the truth from you. When your whole life breaks down,” says Palahniuk. “That’s the moment when you have to somehow choose what your life it going to be about.”

See, for Palahniuk, life is all about action — the measures we all take in search for fulfillment that, ultimately, may be just beyond our reach.

Bob Batchelor is a business writer and historian based in San Rafael, Calif. He is currently at work on The 1900s, a book about the intersection of popular culture and history in the first decade of the 20th century for the series American Popular Culture Through History (Greenwood).