Gately's residency: the thing that was working
He couldn’t for the goddamn life of him understand how this thing worked, this thing that was working. It drove him bats.
Context
The payoff to the cake-box: the Removal happens — the Desire and Compulsion lifted from a man who "had been a total hypocrite in even asking something he didn't believe in" — and Gately's intelligence can only stand outside it, baffled. The sentence's whole force is in the collision of the two clauses: he cannot understand it, and it is working, and the understanding-mind's failure to parse the working changes the working not at all. Ferocious Francis closes the trap with the scene's sharpest line — that "maybe anything minor-league enough for Don Gately to understand probably wasn't going to be major-league enough to save Gately's addled ass from the well-dressed Sergeant at Arms." Understanding isn't the road to the thing; it's the obstacle. And by the theme's lights, irony — understanding weaponized — is the disease's last redoubt.