Let's start with the sheer intensity of the images presented to us. The very first line, "The woman in front of him was eating roasted peanuts that smelled so good that he could barely contain his hunger," (1) signals that this will be a story of extremes.
We learn that Laura will die unless he gets money to pay a doctor. Notice that she is not sick or near death or even dangerously ill. The issue is framed as: "Laura 'bout to die 'cause we got no money for a doctor" (16). Later, "the smell of peanuts stabbed him like a knife" and "he saw a row of intense-faced young girls" (16). Once he has swallowed the whiskey, he faces a lethal combination of hunger, depression, and alcohol. Together, they push him into a crazed tailspin.
The intense images and feelings help contribute to the sense that the entire story is positioned on the edge of sanity. Welcome to surrealism, ladies and gentlemen. Other aspects of the story demonstrate hallmarks of the genre as well: the dream that allows us to probe the protagonist's subconscious, the interaction between the protagonist and the spinning wheel that occurs entirely in the protagonist's mind, and the descriptions of how the "audience had somehow entered him and was stamping its feet in his stomach" (74).