To pass the time, Freemantle takes up sketching and painting and instantly begins turning out masterpieces. But his newfound talent, as well as the scenes he paints, somehow flow through his altered brain from the supernatural. His phantom right arm also gives him a connection to the other plane, and when the missing arm begins to itch, the only way to stop it is to paint. On Duma Key, a phantom limb is more than a medical phenomenon; it is a ghostly one as well.
I like fiction that allows us to imagine other planes, other dimensions, where human souls may go after physical death, or from where other spiritual entities dwell (some of them evil or malevolent). King does this very well. The evil spirit in "Duma Key" comes in the form of a china figure that is recovered from old ship wreckage in the surf, uncovered after a hurricane. The spirit's name is Perse and she is nasty and vicious to living souls. She kills people who cross her.
King does not explain how Perse came into existence or why she is antagonistic to humans. It really doesn't matter, however. When walking by a cemetery in the middle of the night, one doesn't generally worry about how malevolent spirits come to be; one only worries about avoiding them.
King's novels are entertainment, but for me they always seem to probe the boundaries of where everyday reality ends and the supernatural begins -- and that's what makes them fun.