Red Shoes plays both sides in what becomes a civil war that devastates both the Choctaw town of Yanàbi and Anoleta's family.

Plot threads include embezzlement, rape, money laundering, and donations to the Irish Republican Army and the Mafia.

The novel explores a number of themes, particularly regarding the circular nature of time and issues of Native American identity.

It explores connections over time, including the concept that when a shilombish (soul) is troubled in life, it casts a shadow over a family that endures until the problem is solved.

In discussing this novel, Howe has explained that, "Native stories ... seem to pull all the elements together of the storyteller's tribe, meaning the people, the land, and multiple characters and all their manifestations and revelations, and connect these in past, present and future milieus.

Shell Shaker has been praised for emphasizing the importance of history in the lives of a Native American group as they deal with decolonization.

Scholar and critic P. Jane Hafen (Taos Pueblo) said in 2002, "Howe seamlessly integrates a history of desperate and gruesome fights for survival with modern Faustian pacts with materialism and wealth.

[5] The novel presents its characters differently from preconceived American ideas: "The variations in voice among the protagonists show that Howe knows how to imagine different characters, and those figures confirm and challenge stereotypes about Native Americans in a way that can only be productive for all readers.

One example is "ten thousand feet of intestines hanging from trees in Yanabi Town", which is finally explained at the end of the novel.

The novel's main themes are expressed in the Choctaw language, including the bloodsucker (osano) and the search for the Greatest Giver (Imataha Chitto).

Claiming to be an animal spirit over 400 years old and a protector of the family, she represents "an openness to life's multiplicity and paradoxes".

[8] Shell Shaker has been praised for its dynamic presentation of characters, without resorting to stereotypes of either whites or Native Americans.