I really cannot stand Chuck Palahniuk, and this story—which I read awhile ago, due to its increasing reputation as being the "most disturbing thing ever" or some such nonsense—only reinforces that he's a one-trick pony. Check out William T. Vollmann's "The Blue Yonder" (it appears in his short story collection, The Rainbow Stories) for something truly horrifying. Hell, just check out Vollmann, period. Better writer than Palahniuk, who's basically Vollmann-lite.