Foden has written this book as if the writer is actually the protagonist Nicholas Garrigan pulling together his memoirs of when he was Idi Amin's physician. The narrative is in the first person, and Garrigan often interjects what he is thinking as he writes the memoir from his cottage in Scotland. Because of this, Foden (through Garrigan's character) often inserts a present-day comment that provides a hint about what is to come in the narrative.