You don't have to be crazy to play this piece, but it helps...the composer includes lots of specific notations to interpret the mood she wants. Some of these are: Rough, explosive... Driven...Obnoxious vibrato (we assume most saxophonists can do this)... Hurried, impatient... Like a train out of control... and, Like a maniac.
Aside from these requirements, the piece calls for advanced playing to the very top of the range, and includes fingerings for multiphonics on the sax.
The piano accompaniment contains notes on playing with fists and palm clusters.
The three sections are I. Obsessive Behavior, II. Lost, and III. Fits and Fists. Contains alto sax part and piano score. This should be quite a performance!