The final act opens five years later, once again in the Mayo farmhouse. The home is even more dilapidated—it looks dirty and uncared for. Both Mrs. Mayo and Mary have died in the intervening years, and Ruth, who has “aged horribly” (175), is sat up late by the stove with her sleeping mother. Rob enters looking emaciated; he is clearly ill. Ruth and Rob discuss Andy’s imminent visit, and Rob is annoyed that Ruth has told his brother he is sick with “lung trouble” (177). The couple argue about Rob’s illness, and Rob experiences flashes of jealousy toward Andy, who he feels has made a comparative success of his life. Rob reflects on how hard the last few years have been for he and Ruth, especially Mary’s death, although both believe that Mary is fortunate to be dead rather than having to face their current situation.

Rob feverishly tells Ruth about his dreams of a new life for them both in the city once he’s well, and how he hopes to make a living from writing. Rob thinks Ruth’s reluctance to go with him is because she still loves Andy, and his anger brings on a coughing fit. Ruth agrees to go with Rob to soothe him, but she fears he has gone mad.