I'll admit, back when I first read Stewart Wieck's Malkavian, I skipped chapters here and there, mainly due to the nature of one of the narrators. That would be Anatole, the so called Prophet of Gehenna. Given that the weakness of the clan is that they all suffer from some form of insanity, this may explain why this one takes a bit to get through. Particularly since one of the two major narrators is one of Anatole's personality fragments, and it's the one that actually makes sense.
We actually get 3 lunatics in this mix, as both Prince Bennington and The General from Atlanta show up alive and well. And they indeed dance on Anatole's strings, as he has visions of them and provides them with other visions. (It's worth noting that the Malkavians have a special ability in game call the "Malkavian Madness Network" or "Cobweb" that allows them something akin to telepathy. Not quite that, but close enough for horse shoes and hand grenades.)
So, anyway, Anatole comes to the States from Serbia towards the beginning, following his visions. (He's evidently been following them for some time, as he has the Concorde to himself, having booked the flight years earlier.) All the characters of note seem to have Animal representations in his visions, with the other puppeteers showing up as nightmarish predators.
This leads first to New York City, then to Atlanta, where he leads the General to a newly returned Victoria Ash and Bennington to the Tremere chantry to get the robe that killed Heracles. With all the pieces in place, Anatole is free to travel to the Catskills where Leopold is still sculpting. (This is after revealing to Victoria that she sired Leopold. Which neither of them remember.)
Anatole ends up sacrificing himself in the cave, using his own blood to scroll prophecy on the reborn Cathedral of Flesh. In an epilogue, Ramona and Hesha arrive together, wherein Ramona kill her Sire and clanmates stuck in the walls of the cathedral while Hesha takes pictures of and makes copies of Anatole's writings.
So, upon rereading this, it's better than I remember, and the visions do make more sense, particularly since having read the series before (and reading them closer together), I actually can figure out what the heck he's actually describing. And added bonus is finally seeing Victoria use her combat prowess to take her revenge of Elford, who mutilated her so madly several books ago.