If you've been through the school system, you're probably familiar with the story about the man who mysteriously turned into a vermin (that's the technical translation from German; "cockroach" is what the English translators decided to make it).  Then the man/vermin's world shrinks and he finally dies from an infection caused by an apple stuck in his back.

This is a continuation of ideas presented in part 1, "The Giver Culture".