Francie eagerly anticipates school, but before any child can go to school, he or she must be vaccinated. This ritual brings much consternation to the foreign and uneducated families in Brooklyn. Katie does not go with Neeley and Francie to get their vaccination mostly because she cannot stand the thought of it. Neeley is frightened, and Francie tries to cheer him up by making mud pies with him. When the children show up for the vaccination, their arms are caked in mud. The doctor makes a series of comments to the nurse about how filthy poor families are, and the nurse, a Williamsburg girl now grown up, plays along, not wanting the doctor to know her background. Francie, keen and observant, hears it all and feels thoroughly ashamed. She futilely expects the nurse to act motherly, and defend Francie. The narrator comments that the person who makes it out of the slums "via the boot-strap route" has two choices: to forget his past, or "keep compassion in his heart for those he left behind." This nurse forgot. Aware of the cruelty of his comments, Francie tells the doctor not to say the same things to Neeley. The doctor is taken aback that Francie understood his comments.
Francie's arm becomes infected, and Katie scares her into not scratching it. One night, Francie cannot sleep, afraid that she will die any minute. Johnny comes home and washes her arm, soothing her fears. He wraps it with his own undershirt. That night, Johnny resists Katie's affection in bed, and lies awake in the dark instead.
Francie has great expectations for school, but coming home with a bloody nose the first day is not a good start. She also realizes she will never be teacher's pet, since Miss Briggs likes all the rich children, and consigns the others to the back of the room. The narrator remarks that one would expect unwanted children to band together against a common evil, but instead, the poor children tend to turn against each other.
The school is a brutalizing place, with three times as many children as the facilities can hold. The students are punished brutally. Almost all the teachers are cruel, as the nicer ones get married, or are driven out by the mean ones. During recess, the bullies will not let anyone into the bathroom, and the teachers will not excuse the kids from class. Half of the kids learn to hold it, and half became pants-wetters.
As time goes by, Sissy remains condemned from the Nolan household. She wants to see Francie and Neeley so desperately that she comes by the schoolyard one day, and takes Francie for a soda. Francie is cold, and she shamefully tells Sissy she has wet her pants. Sissy tells Francie that from now on, the teacher will let her leave. The next morning before school, Sissy threatens the teacher, telling her that she is Francie's mother, and her husband is a cop, and Francie has a kidney infection that could lead to death. The teacher excuses Francie to the bathroom from that day forward.
Katie is committed to keeping Sissy away from her house, but when she hears that Sissy has another stillbirth, she feels ashamed of herself, and lets Sissy return.