A Choir of Ill Children

A Choir of Ill Children is a horror novel set in a swampy backwater town, with a cast of grotesque characters: triplets joined at the head sharing a single brain, granny witches, religious zealots speaking in tongues, a murdered nun, and drugged-up film students. Meanwhile, Piccirilli is very good writer (in a genre not known for them):

The Crone tires quickly and reaches out for the velvet draperies, sits on the divan, breathing heavily. She's too ancient to have a name any longer. When she coughs you can hear the ages rattling inside her shrunken frame. No human names can cling to her any more- they slip from her dusty shriveled flesh like a young girl's whimsies.

[...]

They walk the wire across the chasms of their own souls, looking down into the great depths as, step by step, they cross to the distant side. On occasion they’ve learned something by the time they get there, but not always, and usually not what they expect.

This is a solid Southern Gothic horror novel.