I am Joe's Metaphors
The author of this novel foregoes the use of similies, and instead uses only metaphors to make the writing even more intense. Here are a few examples.

"I am the toxic waste by-product of god's creation."
"I am Ozymandias, king of kings"
(Describing Marla): "skim milk thin"
(Describing diners at a restaurant): "each mouth... a tearing Stonehenge of ivory"

During the course of the novel, the narrator finds reader's digest magazines around the house, which contain articles written by body parts in the first person (I am Joe's Prostate). These comparisons are used by the author to show complex emotions of the narrator throughout the novel. Here are some examples:
I am Joe's Prostate
I am Joe's Raging Bile Duct
I am Joe's Grinding Teeth
I am Joe's Inflamed Flaring Nostrils
I am Joe's White Knuckles
I am Joe's Enraged, Inflamed, Inflamed Sense of Rejection
I am Joe's Clenching Bowels
I am Joe's Boiling Point
I am Joe's Blood Boiling Rage
I am Joe's Smirking Revenge
I am Joe's Broken Heart
I am Joe's Complete Lack of Suprise
I am Joe's Shrinking Groin
I am The Pit of Joe's Stomach
I am Joe's Hard Drive