I guess this story is an oddity, a little strange, and with a unique plot. Even the way it's structured is a little out of the ordinary. All that is part of its appeal.
Another hurdle is the colloquial dialogue, something I often have trouble with, especially in stories with a Western theme; In this case though, it works to attach the reader more intimately to the main protagonist. Matt has managed to put the reader inside the skin of Ozzie, and that's not a comfortable place to be. Anyone who's been put down because they don't have the accepted level of physical beauty, too fat, too thin, disfigured, disabled, will identify with him completely.
This is another of those nuggets of pure gold I've talked about in my other reviews. It should definitely be required reading for anyone that feels they're superior to everyone else. For the rest of us it's a must read, if only to learn that the light at the end of the tunnel isn't always a train.