The story follows Tim Underhill, a novelist and Vietnam veteran who is called back to his hometown of Millhaven, Illinois, when the wife of his old friend, religious studies professor John Ransom, is brutally attacked by a Serial Killer. The killer is apparently copying the earlier "Blue Rose" murder spree from forty years earlier, which included Underhill's sister as one of the victims. With the help of Underhill's friend, the reclusive amateur detective Tom Pasmore, he and Ransom uncover clues linking the murders to their experiences in Vietnam, and soon find themselves confronting old demons.
The Throat contains examples of:
- Author Avatar: Tim Underhill, a novelist who survived being hit by a car as a child, is clearly a stand-in for Peter Straub himself.
- Ascended Extra: Tim, who was a supporting character in Koko, appears here as the main protagonist.
- Ax-Crazy: Fee Bandolier, a.k.a. Franklin Batchelor, a.k.a. Mike Hogan, was disturbed even as a kid and only got worse after he was sent to Vietnam as a Green Beret.
- Beneath Suspicion: Ransom ruminates that the person who attacked April is a seemingly ordinary person whom most would assume is incapable of such acts. This is a subtle clue pointing not only to Michael Hogan, but to Ransom himself.
- Bitch in Sheep's Clothing:
- Detective Sergeant Michael Hogan is regarded as a Reasonable Authority Figure in Millhaven, when in reality he is a twisted ex-war criminal who can't stop killing.
- John Ransom presents himself as a grieving spouse, when in reality he had been planning to kill his wife April for some time in order to get her money. He also killed another person, a student at the college where he worked, in order to blame everything on a serial killer.
- Consulting a Convicted Killer: At Tom's suggestion, Tim and John interview Walter Dragonette in an effort to understand the copycat killer.
- Continuity Snarl: In Mystery, it was Tom who was forced to recover from being hit by a car as a child. Here, that experience is transferred over to Tim Underhill, which wasn't mentioned in Koko.
- Conveniently Interrupted Document: Tim finds a scrap of paper with a name and a town written on it, only the town name is slightly damaged and looks like "Alle_to_n". He misreads it as Allentown, which leads him to entirely the wrong man; the real murderer was in Allertown.
- Contrived Coincidence: The final Plot Twist hinges on the fact that Ransom is exploiting the original Blue Rose murders while having no idea (at the time) that the killer was Bob Bandolier, that his son Fee even existed, that Fee is living in Millhaven, or that Fee just so happens to be the very Franklin Bachelor who was Ransom's arch-enemy in Vietnam and who Ransom is framing as the second Blue Rose killer.
- Dirty Cop: The Millhaven police are depicted as incompetent and racist, and they engage in a coverup when Detective Fontaine is implicated in the copycat murders.
- Expy: Fee Bandolier/Franklin Batchelor's backstory in Vietnam, being a renowned military operative who goes insane and leads a rogue Montagnard army deep in the jungle, is clearly inspired by Colonel Kurtz in Apocalypse Now. Ransom, in turn, becomes an expy for Willard, having been assigned to bring him back from the field.
- Great Detective: Tom is internationally famous for his work in reexamining old cases and exonerating wrongfully-convicted prisoners. He shuns the spotlight, however, and lives as a recluse.
- He Who Fights Monsters: John Ransom was sent by the CIA to remove Franklin Batchelor from command after he crossed one too many lines, only to become just as bad as Batchelor.
- I Am a Humanitarian:
- Walter Dragonette, the book's Jeffrey Dahmer Expy, keeps body parts in his refrigerator and freely admits to eating pieces of his victims.
- Upon learning that the CIA was sending someone to bring him back to the U.S. for questioning, Major Batchelor murdered most of his Montagnard followers, then cooked and ate their flesh. It turns out that was actually Ransom's doing.
- No Celebrities Were Harmed: Walter Dragonette is based on Jeffrey Dahmer, right down to Dahmer's choice of victim, modus operandi, and the fact that police ignored warnings from his neighbors. Dahmer was active in Straub's hometown of Milwaukee, which Millhaven is based on.
- Nice Job Breaking It, Hero: Underhill and Pasmore realize too late that Detective Fontaine never was Fee Bandolier, meaning that their actions resulted in the death of an innocent man while the real killer remained at large.
- Red Herring: Several:
- Walter Dragonette is undoubtedly a particularly disturbed serial killer, but it quickly becomes apparent that he is not the new Blue Rose killer.
- Neither is Paul Fontaine, who is misidentified as Fee Bandolier.
- While Bandolier was also a serial killer and staged one of his killings to look like a Blue Rose murder, he also wasn't the new Blue Rose killer. Tim ultimately realizes that the killer is John Ransom.
- Rewatch Bonus: The book reads way differently after you learn that Michael Hogan is Fee Bandolier and that Ransom is the copycat:
- During his initial reunion with Underhill, Ransom comments that the killer is probably an ordinary-looking person who goes about life as normal between his killings. This turns out to be an apt description of Ransom himself.
- At disparate points, both Bandolier's father and Det. Sgt. Michael Hogan are said to bear resemblance to Clark Gable.
- When Underhill asks Colonel Hubbel to identify Bandolier from a group photo of Millhaven police officers, the text specifies that Hubbel points his finger "on top" of Fontaine's face. What Underhill and the reader don't realize is that Hubbel is really pointing at Hogan.
- Sociopathic Soldier: Fee Bandolier, while serving in Vietnam as Major Franklin Batchelor. "And how" doesn't even begin to cover it. Although the worst of Batchelor's alleged crimes were really committed by Ransom.
