Xavier Coates lives and handles maintenance at Leigh Pierce Estates, a low-rise apartment building. While the rent is affordable, its tenants are saddled with a neglectful property manager who’s waiting to tear the place down—he certainly doesn’t care that some tenants have been disappearing lately. Xavier, however, has compassion for others, including an ailing girl he spots in the basement. He calls her an ambulance, but not before her blood apparently infects Xavier, who gets progressively sicker in the coming days. Meanwhile, Ari and his parents, Leena and Cyril, have been moving around the basement units. They’re searching for ways to satisfy their hunger pangs, though what they’re really feeding is some kind of parasite. It’s the very thing that’s affecting Xavier (he’s seen signs of what’s inside him) and just what Ari’s family can help him with, but Xavier may not like how they get their food—or what it is. Cox’s endlessly unnerving story takes repeated shots at health care in America: Xavier gets a massive hospital bill despite being on his mother’s insurance, and a medical professional looking into the parasites isn’t especially concerned about Leigh Pierce or the low-income area it’s in. Along with classism, the novel tackles themes of sexism and racism (several tenants, including Xavier, are Black). All the while, the author confidently delivers the genre goods, blending Cronenbergian body horror with a pervasive sense of doom. A touch of ambiguity (what exactly are those parasites?) heightens the suspense. The prose is richly textured—the narrative has striking passages throughout, such as a description of “metal hitting the fallen log with a hollow ring. A sound like a skull splintering open. The bleeding ooze of wood pulp.”