Carrie graduates from nursing school and goes to work for Miles in Pond Creek, on the border of West Virginia and Kentucky, at the coal mine where Miles is the superintendent. She rents two rooms in a clubhouse for single women while Miles lives in the “big house.” Typhoid spreads through Pond Creek and several coal miners die. Carrie tells Miles that the typhoid is due to the unsanitary sewage facilities, which are located close to the drinking water. She urges Miles to ask his bosses for money to build new outhouses and sewage facilities, but they write back saying “there was no money in the budget for such frills” and that the typhoid was caused by “the filthy habits of the miners and their families” (93). Carrie is furious, but Miles says there is nothing he can do.

One day, while the doctor is out, a man with a broken foot is brought to the doctor’s office. Carrie insists on bringing him to the hospital in West Virginia, but as she brings him aboard the train, he refuses, saying he can’t step foot in West Virginia. Carrie reluctantly takes him to see a doctor at a different nearby coal company instead.