Cormac McCarthy's "Suttree" is a reading experience that stretches far beyond ordinary plot, structure and literary flow. With words that ebb, flow, tumble and roll—some valid and some concocted—McCarthy takes his reader through the moods, dreams, and dark inner life of his protagonist, Bud Suttree, as well as the inner life and underbelly of Knoxville, Tennessee. The despair of a small community of broken people living haphazardly without hope for the future is exaggerated by the unimaginable filth, corruption, and pollution of a river town that takes no pity on poverty, but perpetuates it with constant reminders of lack and the lure of alcohol.

Cornelius "Bud" Suttree lives in a broken-down houseboat on the river where he fishes for carp and catfish to make a meager living. As poor as his circumstances are, he lives better than some of his friends, with a little heat and a bed. A conversation with his uncle reveals that Suttree's father married "beneath" his station, Suttree's mother being a housekeeper. He is estranged from his family entirely, and part of his mental anguish is rooted in his knowledge that his identical twin died at birth. He grew up as a privileged child in a large house, now abandoned, that he occasionally returns to at different times in the story.

Suttree spends some time at the "workhouse," or county jail, and breaks down when his mother comes to visit. He meets a dim-witted boy in jail named Gene Harrogate, who will re-enter Suttree's life more than once through the course of the story. Rowing himself down the river, Suttree spends some time camping near a poor family with whom he becomes acquainted. The young daughter begins to visit him in the night, and Suttree, perhaps, falls in love with her. But, a rockslide takes her life and that of her mother, and Suttree quietly rows away. During this period of time, Suttree meets identical twins who can read one another's thoughts and whose lives are always in sync, even when they are not together. This is significant because Suttree's life is an enigma. He is well-spoken and kind, but associates with drunks and thieves, and lives a sad, aimless life. Reference is made several times to the loss of his twin at birth and it is clear this has affected his life.

After the death of his young son, Suttree's brave attempts to avoid alcohol fail. He gets seriously injured in a bar brawl but leaves the hospital.

Alcoholism and depression send him on a lonely retreat into the mountains where he almost perishes from exposure and hunger. Returning to his houseboat he returns to his old ways, passing time with his friends in the bars, doing a little fishing, and simply existing. He gets involved in a relationship with a prostitute, who regularly leaves town and brings money back to him. They buy a car and, although saturated with alcohol, they spend some time in some semblance of a routine in a rented apartment. The woman is not mentally well and they part ways, with Suttree returning to his houseboat.

Suttree has several encounters with family members, including a derelict uncle, his father, his mother, and a kind old aunt. In his own way he tries to piece together the puzzle of his pain. However, it seems that there are many elements and, in the end, too many for him to sort through. After coming close to death from typhoid fever, Suttree goes back to McAnally Flats, which is being torn down and destroyed to make way for urban development. In his usual, detached manner, Suttree walks away from what has been his home.

A true "slice of life" story, this novel is poignant, sad, and oddly comical. Jumbling his copious words, omitting punctuation, using obscure terms, and often writing more in the manner in which a human brain thinks, McCarthy gives us a glimpse of meaning behind the lives of people who seem to waste their time on earth with substance, despair, and drama, and one man's choice to join them, at least temporarily.