Altered contains three parts: In "Juggling Butter Sticks," Earle writes short stories about a disabled man, cigarettes, a Jameson bottle, a cocaine addict, an interracial couple, and many more charming and beautiful characters. "Ron's Place" is Mick Kessler's narration from his days as a cashier at a local gas station in southern Minnesota. In a letter written to his psychiatrist, Kessler writes with great immediacy showing his slacker days at work. "Felsted's Paradise"-Addictions-Tattoos-A dog-Dreams-A dysfunctional relationship-Games-Rock-N-Roll