“Filth, filth, filth, from morning to night. I know they're poor but they could wash. Water is free and soap is cheap. Just look at that arm, nurse.'The nurse looked and clucked in horror. Francie stood there with the hot flamepoints of shame burning her face. The doctor was a Harvard man, interning at the neighborhood hospital. Once a week, he was obliged to put in a few hours at one of the free clinics. He was going into a smart practice in Boston when his internship was over. Adopting the phraseology of the neighborhood, he referred to his Brooklyn internship as going through Purgatory, when he wrote to his socially prominent fiancee in Boston.The nurse was as Williamsburg girl... The child of poor Polish immigrants, she had been ambitious, worked days in a sweatshop and gone to school at night. Somehow she had gotten her training... She didn't want anyone to know she had come from the slums. After the doctor's outburst, Francie stood hanging her head. She was a dirty girl. That's what the doctor meant. He was talking more quietly now asking the nurse how that kind of people could survive; that it would be a better world if they were all sterilized and couldn't breed anymore. Did that mean he wanted her to die? Would he do something to make her die because her hands and arms were dirty from the mud pies?She looked at the nurse... She thought the nurse might say something like:Maybe this little girl's mother works and didn't have time to wash her good this morning,' or, 'You know how it is, Doctor, children will play in the dirt.' But what the nurse actuallly said was, 'I know, Isn't it terrible? I sympathize with you, Doctor. There is no excuse for these people living in filth.'A person who pulls himself up from a low environment via the bootstrap route has two choices. Having risen above his environment, he can forget it; or, he can rise above it and never forget it and keep compassion and understanding in his heart for those he has left behind him in the cruel upclimb. The nurse had chosen the forgetting way. Yet, as she stood there, she knew that years later she would be haunted by the sorrow in the face of that starveling child and that she would wish bitterly that she had said a comforting word then and done something towards the saving of her immortal soul. She had the knowledge that she was small but she lacked the courage to be otherwise.When the needle jabbed, Francie never felt it. The waves of hurt started by the doctor's words were racking her body and drove out all other feeling. While the nurse was expertly tying a strip of gauze around her arm and the doctor was putting his instrument in the sterilizer and taking out a fresh needle, Francie spoke up.My brother is next. His arm is just as dirty as mine so don't be suprised. And you don't have to tell him. You told me.' They stared at this bit of humanity who had become so strangely articulate. Francie's voice went ragged with a sob. 'You don't have to tell him. Besides it won't do no godd. He's a boy and he don't care if he is dirty.'... As the door closed, she heard the doctor's suprised voice.I had no idea she'd understand what I was saying.' She heard the nurse say, 'Oh, well,' on a sighing note.”

“A person who pulls himself up from a low environment via the bootstrap route has two choices. Having risen above his environment, he can forget it; or, he can rise above it and never forget it and keep compassion and understanding in his heart for those he has left behind him in the cruel upclimb. The nurse had chosen the forgetting way. Yet, as she stood there, she knew that years later she would be haunted by the sorrow in the face of that starveling child and that she would wish bitterly that she had said a comforting word then and done something towards the saving of her immortal soul. She had the knowledge that she was small but she lacked the courage to be otherwise.”

“From somewhere Marla heard a terrifying scream--her scream--and she lunged at Martin, hitting him in the chest. When she hit him once, she couldn't stop. All of those times he had hurt her, and all of those times she had lied for him, protecting him so no one would find out. After all, he was a professional man, a doctor. He could be ruined if something like that got out. The good, kind doctor. He took care of people. He took care of her. She was one of those pitiful, unfortunate people who seemed to always have accidents. Bruises on her face and body, cuts and abrasions. It was so nice she was married to such a good doctor. Everyone admired him--auch a wonderful man. But he didn't hurt them. Only her. And now, Gale.”

“When the examination was over, the doctor looked at his watch, and then Praskovya Fyodorovna informed Ivan Ilyich that it must of course be as he liked, but she had sent today for a celebrated doctor, and that he would examine him, and have a consultation with Mihail Danilovich (that was the name of his regular doctor). 'Don't oppose it now, please. This I'm doing entirely for my own sake,' she said ironically, meaning it to be understood that she was doing it all for his sake, and was only saying this to give him no right to refuse her request. He lay silent, knitting his brows. He felt that he was hemmed in by such a tangle of falsity that it was hard to disentangle anything from it. Everything she did for him was entirely for her own sake, and she told him she was doing for her own sake what she actually was doing for her own sake as something so incredible that he would take it as meaning the opposite.”

“She did understand, or at least she understood that she was supposed to understand. She understood, and said nothing about it, and prayed for the power to forgive, and did forgive. But he can't have found living with her forgiveness all that easy. Breakfast in a haze of forgiveness: coffee with forgiveness, porridge with forgiveness, forgiveness on the buttered toast. He would have been helpless against it, for how can you repudiate something that is never spoken? She resented, too, the nurse, or the many nurses, who had attended my father in the various hospitals. She wished him to owe his recovery to her alone—to her care, to her tireless devotion. That is the other side of selflessness: its tyranny.”

“Children are taught to look down on their nurses (nannies), to treat them as mere servants. When their task is completed the child is withdrawn or the nurse is dismissed. Her visits to her foster-child are discouraged by a cold reception. After a few years the child never sees her again. The mother expects to take her place, and to repair by her cruelty the results of her own neglect. But she is greatly mistaken; she is making an ungrateful foster-child, not an affectionate son; she is teaching him ingratitude, and she is preparing him to despise at a later day the mother who bore him, as he now despises his nurse.”