This fast-paced thriller is deliciously gory! Narrator Christoper Lee is amazing and gives an all-out performance. There are a wide variety of characters, from the Katherine Hepburn-esque grandmother to cleft-palate mutants and he makes them all come alive.
I managed to listen to the whole thing, but I found myself wishing it would be over about halfway through.
This was not, as implied, a supernatural story and I still have no idea what the titular "presence" was supposed to have been. Rather it was an awful attempt at a medical thriller a la Michael Crichton. Characters weren't developed at all and I found myself just not caring what happened. I have read and listened to a number of John Saul novels and generally like his work. Do yourself a favor and skip this one!
The male narrator did not do a good job with the female protagonist's dialog: he made her sound whiny and annoying. Likewise with the Hawaiian and Japanese accents.
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