Choke follows Victor Mancini and his friend Denny through a few months of their lives with frequent flashbacks to the days when Victor was a child.[1] Victor grew up while going from one foster home to another. Victor's mother was found to be unfit to raise Victor. Several times throughout his childhood his mother would kidnap him from his various foster parents. They would eventually be caught and he would again be rehanded over to the government child welfare agency.
In the present day setting of the book, Victor is now a man in his mid-twenties who left medical school in order to find work to support his feeble mother who is now in a nursing home. He cannot afford the care that his mother is receiving so he resorts to being a con man. He consistently goes to various restaurants and purposely causes himself to choke mid-way through his meal, luring a "good Samaritan" into saving his life. He keeps a detailed list of everyone who saves him and sends them frequent letters about fictional bills he is unable to pay. The people feel so sorry for him that they give him money, send him cards and letters asking him about how he's doing, and even continue to send him money to help him with the bills.
While growing up, Victor's mother taught him numerous conspiracy theories and obscure medical facts which both confused and frightened him. It is because of this and his constant moves from one home to another that has left Victor unable to form lasting and stable relationships with women. Victor therefore finds himself getting sexual gratification from women in sexual addiction support groups.