Misery, an engaging, detailed novel, creates some of its greatest effects through its structure. This psychological thriller is also about writing a romance novel. The paperback edition, for example, has a double front cover: the outer cover depicts a man in a wheelchair menaced by the shadow of an ax-wielding woman; the inner cover is Misery's Return, complete with a buxom beauty wrapped around a barechested man bearing a striking resemblance to Stephen King. The novel also contains chapters of Misery's Return, which appears in larger type or as handwritten manuscript. This structural intermixing of different fictions within the novel reflects Paul's own mixture. As Annie, the psychotic nurse, becomes a bitch-goddess, Misery Chastain, the proper romance heroine, becomes a Bourka bee goddess.

The first page of the novel, after the dedication, has two words on it, like an invocation: "goddess" and "Africa," words that carry both positive...