Amidst the swamp of other responsibilities, Jackie fails to have her children immunized for measles, mumps, and rubella. Abraham argues that this failure is not a symptom of incompetent parenting but rather the result of inadequate communication by government-funded immunization programs. Inconsistent immunization policies throughout the city and a lack of vaccination-tracking systems have led to dangerous levels of unimmunized children in Chicago’s poorest neighborhoods. Abraham finds that some immunization clinics are even unaware of the names of their own programs and cannot, therefore, be expected to communicate with parents effectively about the programs for which their children are eligible. Simple communication from doctors, such as a letter reminding her about the upcoming vaccinations, might have helped Jackie to make sure that her children were immunized. However, no such communications occurred.

While Jackie manages Cora’s at-home care and potential placement in a nursing home, Robert vies for a spot on the state’s kidney transplant waiting list. Since decisions about who is admitted to the waiting list are up to the personal discretion of individual doctors, Robert believes that he has to impress his doctor to get a coveted spot. This leads him to misrepresent his drug use to his doctor since he knows that drug users are more likely to be denied transplants.