Choke

It starts off like you would expect a Palahniuk story to, with sex, only this time it's in a support group about sex, which in turn leads to the act at hand. Victor can't seem to escape his inner demons, only truly revealed in the book, so he uses sex as his vice to keep himself numb. Numb from dropping out of medical school, numb from working at a colonial reenactment facility, numb from choking at restaurants and asking the people who save him for money, numb from his mother suffering from dementia, numb from paying off the bills for her stay at St. Anthony's, numb from confessing to all the complaints of the residents there. You get the idea, his life sucks so he buries himself in the one thing that can make him forget all the problems in his life.
He even admits that smelling a rose will never compare to having an orgasm, and to him that is all too true. But this all comes to a halt when he first sees Dr. Marshall and doesn't picture her naked, unlike all the other women in the film up to this point.
What she gives him is a chance to break free from the void, a life before all these problems, and before his childhood growing up with a sociopath and foster parents. But when he finally gets the chance to do what he wants, literally, he can't get it up with her and this provides the structure for the film. It is supposively to save his mother's life, which he doesn't want to do, but he contunues to try.
All in all I thought it was as fun as a movie about a Palahniuk story can be, yet missing a key piece to keep his readers interested. Don't get me wrong, the book is great, but the movie digreses from the restaurant scenes and doesn't really hit on the true character that is Vincent. It lacked the modesty and details that make the overall story complete, but the twist is killer and bound to make the whole thing worthwhile. However, be advised that the witty comments are only half as good spoken from Sam Rockwell, he embodies this character but there are twice as many in the real medium.