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Deconstructing Health
Inequity
A Perceptual Control
Theory Perspective

Timothy A. Carey
Sara J. Tai
Robert Griffiths

Foreword by Neil Gilbert

Deconstructing Health Inequity
 Timothy A. Carey · Sara J. Tai ·
Robert Griffiths

Deconstructing
Health Inequity
A Perceptual Control Theory Perspective
Timothy A. Carey Sara J. Tai
Institute of Global Health Equity University of Manchester
Research Manchester, UK
University of Global Health Equity
Kigali, Rwanda

Robert Griffiths
University of Manchester
Manchester, UK

ISBN 978-3-030-68052-7 ISBN 978-3-030-68053-4 (eBook)

https://doi.org/10.1007/978-3-030-68053-4

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer
Nature Switzerland AG 2021
This work is subject to copyright. All rights are solely and exclusively licensed by the
Publisher, whether the whole or part of the material is concerned, specifically the rights
of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on
microfilms or in any other physical way, and transmission or information storage and
retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc.
in this publication does not imply, even in the absence of a specific statement, that such
names are exempt from the relevant protective laws and regulations and therefore free for
general use.
The publisher, the authors and the editors are safe to assume that the advice and informa-
tion in this book are believed to be true and accurate at the date of publication. Neither
the publisher nor the authors or the editors give a warranty, expressed or implied, with
respect to the material contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional claims in published maps
and institutional affiliations.

Cover illustration: © John Rawsterne/patternhead.com

This Palgrave Macmillan imprint is published by the registered company Springer Nature
Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
 Foreword

In recent years concerns about increasing inequality have animated the

study of social and health disparities. The considerable growth of research
in this area has produced an impressive body of literature focussed on
the proportional differences in adverse social and health outcomes found
among geographic regions, usually wealthy countries, as well as within
demographic groups, typically categorised by gender, race, ethnicity, and
sexual orientation. Disparities research encompasses a wide range of prob-
lems including, mental illness, homicide, imprisonment, infant mortality,
alcoholism, drug addiction, life expectancy, school dropouts, obesity, and
single parenthood. Efforts to explain these problems frequently attribute
the proportional differences that appear in both geographic and demo-
graphic studies to abstract structural forces. On the demographic level, for
example, disparities among racial groups are often depicted as resulting
from systematic barriers of institutionalised racism. And the presumed
impact of economic inequality exemplifies the conventional explana-
tion for health disparities among geographic regions. Concentrating on
the latter, Timothy Carey, Sara Tai, and Robert Griffiths’ book poses
a formidable intellectual challenge to the prevailing assumptions that
undergird the health inequities literature in particular and the disparities
research in general.
Deconstructing Health Inequity: A Perceptual Control Theory Perspective
is a nuanced study that illuminates the theoretical, logical, and empirical
limitations, which pervade the health inequities research. On a theoretical

v
vi FOREWORD

level the analysis draws attention to the classic issue concerning the impact
of structure and agency on human behaviour. From a structural perspec-
tive, individual outcomes are seen to be governed by abstract forces (e.g.
class, institutionalised racism, economic inequality) emanating from the
social structure; from the perspective of agency, outcomes are seen as
more influenced by subjective responses to the environmental context in
which one exists.
Carey, Tai, and Griffiths’ analysis underscores the extent to which the
abstract forces of structural theory dominate the explanation of health
inequities. Seeking to clarify the theoretical basis for the prevailing expla-
nation of health inequities, they ask the logical question: What is the
causal link between economic inequality and adverse health outcomes?
According to Richard Wilkinson and Kate Pickett’s widely cited research,
the standard answer is that income inequality generates psychological
stress, which is empirically shown to have deleterious effects on physical
and mental health. Really, ask Carey, Tai, and Griffiths: “Are we really that
fickle as a species that we can become psychologically and socially debili-
tated, as well as seriously compromised by life-threatening physical health
conditions, at the idea of people doing better than us?” And how does
this causal line of reasoning square with Wilkinson and Pickett’s finding
that people tend to compare themselves with others who were similar to
them, not those considerably higher on the economic ladder or the reality
that most people do not know the degree of inequality in their country,
how much it is changing and where they place in the income distribution.
Stress may cause illness, but there is no empirical evidence that inequality
(not abject poverty) causes stress.
This persuasive analysis of the implausible line of reasoning in the
economic-inequality-health-inequities chain of causality is followed by
the authors’ painstaking examination of the empirical evidence, which
reveals a body of research racked by methodological weakness, statistical
anomalies, contradictory findings, and a general absence of conceptual
clarity. Indeed, their findings lend detailed substantive verification to an
earlier review of 98 studies that reports “little support for the idea that
income inequality is a major, generalizable determinant of population
health differences within or between rich countries”.1

1 Lynch, J., Smith, G. D., Harper, S., Hillemeier, M., Ross, N., Kaplan, G. A., et al.
(2004). Is income inequality a determinant of population health: part 1. A systematic
review. Milbank Quarterly, 82(1), 5–99.
 FOREWORD vii

Going beyond the deconstruction of health inequities, as the book’s

subtitle signals, the authors introduce an alternative approach to concep-
tualising the problem. In contrast to the dominant perspective of struc-
tural theory, they argue for examining health inequities through the
alternative lens of agency as expressed in perceptual control theory.
This perspective involves seeing health as essentially an individual affair
and shifting the variable of individual control to centre stage of health
outcomes. The extent to which perceptual control theory can deliver a
precise scientific understanding of health inequities is for the reader to
decide.
Deconstructing Health Inequity raises intriguing questions about the
theoretical and empirical foundations of disparities research. It is a
rigorous application of critical thinking that elevates the analysis of
economic inequality and health inequities to a new level.

Berkeley, CA, USA Neil Gilbert

Neil Gilbert is the Milton and Gertrude Chernin Professor of Social Welfare at
the University of California, Berkeley.
 Preface

A no-holds-barred-warning of what’s ahead.

We hadn’t originally planned a Preface for this book, however, some very
useful suggestions by two anonymous reviewers encouraged us to see the
value in pre-empting what you might be about to encounter.
There is a Congolese saying that:

No matter how hard you throw a dead fish in the water, it still won’t swim.1

We think this wisdom is a fitting way to set the context for the Preface. In
many ways, this short introduction is a warning of what lies ahead. This
book is about letting go of that fish so it can drift away.
We are not even recommending seeking another fish from the same
body of water. Fundamentally, this book is a suggestion that we visit an
alternative body of water where there are different fish, even fish that
swim against the current. There might even be creatures we haven’t yet
anticipated.
If you are satisfied with the current state of play in the health inequity
field, this book will not be for you. You might think that there is more

1 Stearns, J. K. (2011). Dancing in the glory of monsters: The collapse of the Congo and
the Great War of Africa. New York: PublicAffairs.

ix
x PREFACE

work to do in the sense of clarifying concepts, refining theories, iden-

tifying mechanisms, and resolving empirical anomalies. Overall though,
you perhaps think that the field is generally moving in the right direction,
incrementally constructing its knowledge base and addressing problems
of inequity.
We don’t agree.
So, as candidly as possible, we want to let you know, that if the above
sentences provide a more or less accurate portrayal of your attitude and
approach, you might not want to read any further. If you’re not inclined
to consider radically overhauling the foundational assumptions of the
field, you are likely to be more irritated than inspired by our words. You
might even form the impression that we are disingenuous peddlers of
snake-oil and other potions.
More than anything, this book is a description of some of our experi-
ences as we studied more about health inequity. As experienced health
practitioners and researchers with a strong sense of social justice, we
wanted to understand the important conclusions being offered.
The more we discussed and deliberated over ideas within the field of
health inequity, however, the greater was our sense of bewilderment. We
approached the field from the theoretical perspective identified in the
subtitle of this book—Perceptual Control Theory—so we were openly
bringing an established set of premises to our learning.
We think this particular theoretical lens has something to offer. Some-
thing monumental in fact. Our brash suggestion is that inequity, per
se, is not the problem. We go to some lengths throughout the book
to explain this position. Instead, we offer, that disrupted control is the
problem. Addressing inequity directly will only correct disrupted control
indirectly. Addressing control directly, however, will necessarily correct
inequity wherever it is a problem. Health inequity, income inequity, social
inequity, inequity of opportunity, and other forms of inequity could all be
dealt a knockout blow if we can ever figure out how controlling creatures
can inhabit the same environment without hindering, and perhaps even
helping, each other’s controlling efforts.
So, there you have it. That’s where we are coming from.
In this book, we offer an invitation to contemplate what possibilities
might emerge from considering health inequity through a lens that is
radically distinct and disconnected from the current view.
Therefore, in this book, we don’t provide an exhaustive overview of
the health inequity field that demonstrates how wholeheartedly we have
 PREFACE xi

engaged with the current body of knowledge. We do provide a summary

of the sources we have studied and we’re reasonably sure that we haven’t
neglected any major contributing idea or school of thought but there will
no doubt be one or more authors we haven’t considered in detail.
We also don’t offer prescriptive solutions or a detailed plan about
what to do next. This book is about alternative questions we might form
when wearing entirely different glasses. Our ambition is that the ques-
tions we pose and the preliminary suggestions we sketch will energise
other researchers working in this field.
In the book, we don’t allocate effort to persuading or cajoling you that
these ideas are concepts you should cherish and adopt. Our priority has
been to ensure that the material we present is as accurate and precise as we
can make it. For the reasons we have outlined above, we are very aware
that this will not be a book for all readers, so we have endeavoured to
steer away from efforts to convince you. We did strive, however, to present
enough information in an accessible manner so that you could convince
yourself if that is what you want to do. The references we provide might
assist further with that.
We have not set out to be unnecessarily provocative or heretical. That
said, sometimes, considered and systematic disruption can be exactly
what is needed. Perhaps for some, this book will frustrate, provoke, and
unsettle. From that upheaval, new insights might sprout and flourish. If
that is you, we hope to meet somewhere along the path to unknown
places. Such an encounter will more than compensate for the many for
whom this book offers little.
Inequity is one of the greatest scourges of our time. It is too important
for complacency. Humanity’s vast potential is at stake. For those with a
penchant for swimming against the tide who are curious about what lies
upstream, there are different waterways yet to be discovered and explored.
We have barely dipped in our toes, but the invitation remains. A more
equitable, socially just world could be ours to create if we can turn
away from the scene that currently dominates our view to contemplate
a different territory.

Kigali, Rwanda Timothy A. Carey

Manchester, UK Sara J. Tai
Manchester, UK Robert Griffiths
 Contents

1 Beginning the Search for Answers 1

2 A Closer Look at the Scientific Literature 21
3 Inequity Through a Different Lens: An Introduction
to Perceptual Control Theory 47
4 Health Through the Lens of Control: A Different Look
at Well-Being and Being Well 69
5 Research Through the Lens of Control: Reflecting
on What We’re Doing from a Different Vantage Point 85
6 Supercharging Our Research Efforts: A Matter
of Control 103
7 Yes! That Really Is What We Mean 121
8 But Wait, There’s More! Control Affects Practice
as Much as Research 139
9 Well That’s That Then. We’re All Controllers All
Controlling Together. So What? 155

Index 169

xiii
 About the Authors

Professor Timothy A. Carey

Director Institute of Global Health Equity Research and Andrew Weiss
Chair of Research in Global Health.
University of Global Health Equity, Rwanda.
Fulbright Scholar.
Author of Patient-Perspective Care: A New Paradigm for Health Services
and Systems and Principles-Based Counselling and Psychotherapy: A Method
of Levels approach.
Dr. Sara J. Tai
Senior Lecturer in Clinical Psychology.
University of Manchester.
Consultant Clinical Psychologist.
Greater Manchester Mental Health NHS Foundation Trust, UK.
Author of Principles-Based Counselling and Psychotherapy: A Method of
Levels approach.
Dr. Robert Griffiths
Director Mental Health Nursing Research Unit.
Clinical Research Fellow in Mental Health Nursing.
Greater Manchester Mental Health NHS Foundation Trust, UK.
Honorary Teaching Fellow.
Division of Nursing, Midwifery and Social Work.
University of Manchester, UK.

xv
 List of Figures

Fig. 1.1 A correlation of −0.31 between two variables x and y 15

Fig. 1.2 Examining different values of health (life expectancy) for a
particular value of income inequity (Gini coefficient) 16
Fig. 3.1 Appearance of the computer screen prior to the
commencement of the tracking task showing the target
and the cursor 50
Fig. 3.2 Results of six tracking experiments performed by the
same person (Tim) with the sixth experiment involving
no control. Red = Cursor; green = Mouse; blue =
Disturbance; black = Model 52
Fig. 7.1 Our interpretation of the model informing Hoff and
Pandey’s (2004) experimental work 123
Fig. 7.2 A model depicting a hierarchical, control system
organisation of the subject matter described by Hoff and
Pandey (2004) 124
Fig. 7.3 A graphical illustration of the amount of overlap between
the groups for the 68.27% of boys who were one standard
deviation above or below the mean of number of mazes
correctly solved 133

xvii
 List of Tables

Table 1.1 An illustration of the way in which income inequities

could manifest in different developed countries 4
Table 1.2 Examples from the literature of aspects of physical,
psychological, and social functioning that are reported to
be linked to income inequity 11
Table 2.1 Reported statements and data sources used to understand
the relationship between happiness and income relative
to neighbour’s income 31
Table 2.2 Terms and descriptions of mechanisms from the health
inequity literature along with their sources 35
Table 3.1 The relationship between accuracy and precision as
important priorities for science 48
Table 3.2 Predicted relationships, based on conventional
psychological knowledge, between a person’s goal, the
person’s actions, and environmental effects 51
Table 3.3 Correlations between each of the pairs of variables over
six trials of the tracking experiment: Cursor and Mouse
(Goal and Actions); Mouse and Disturbance (Actions
and Environment), Cursor and Disturbance (Goal and
Environment); and Mouse and Model (Actions and Test
of Assumptions) 53

xix
xx LIST OF TABLES

Table 3.4 Actual relationships revealed by the tracking experiments

demonstrate a weak relationship between a person’s goal
and the actions used to achieve that goal and a very
strong relationship between the person’s actions and
unseen and unpredictable environmental effects 55
Table 7.1 Means and standard deviations extracted from Table 3
of Hoff and Pandey (2004, p. 35) which relates to the
information they describe on page 13. The range of
scores that represents one standard deviation above and
below each of the means is also reported 132
Table 7.2 Means of number of mazes solved rounded to whole
numbers 133
Table 8.1 Differences in perspective on patient’s quality of life from
Jachuck et al. (1982) and the percentage of incorrect
very next treatment decisions based on that perspective 141
Table 8.2 Recommendations from the National Institute for
Health and Care Excellence (NICE, 2009) regarding
psychological treatment for depression 150
 CHAPTER 1

Beginning the Search for Answers

The true measure of any society can be found in how it

treats its most vulnerable members. Mahatma Gandhi

Sometimes, some things just don’t add up. For us, health inequity is one
of those things.
We have a lot of expertise in the field of mental health. Collectively,
we have accumulated decades of experience working in different settings
with different people. We’ve worked in numerous inner-city services, as
well as rural and underserved communities, in places such as England,
Scotland, Ireland, Australia, the United States (US), and Europe. We’ve
also worked in remote and very remote communities of the central
Australian desert. Since the beginning of 2020, Tim (first author) has
been working at the University of Global Health Equity in Rwanda. We’ve
worked in primary care, secondary care, schools, inpatient wards, and
prisons. We’ve worked with people from a range of different cultural and
ethnic backgrounds, and with a wide range of psychological and social
difficulties. We’ve developed and conducted many hours of training for
other health professionals and have provided countless hours of supervi-
sion for different researchers and clinicians. We’ve created and evaluated
innovations such as patient-led appointment scheduling, an effective and
efficient first-person perspective a-diagnostic cognitive therapy, an online
mental health university course, self-care training for health professionals,
and smart phone apps. Almost our entire professional lives, and a good

© The Author(s), under exclusive license to Springer Nature 1

Switzerland AG 2021
T. A. Carey et al., Deconstructing Health Inequity,
https://doi.org/10.1007/978-3-030-68053-4_1
2 T. A. CAREY ET AL.

deal of our personal ones, have been geared towards helping ourselves
and other people live contented lives.

Entering the Health Inequity Field

Given our interest in effective forms of helping, we recognised that it
was important to not only focus on helping people individually or in
small homogenous groups, but to also consider themes and patterns in
the nature of peoples’ problems more generally, and the implications
that those patterns might have for the help that could be provided.
So, addressing matters such as social justice and inequity on a broader
scale became extremely relevant and interesting to us. We became well
acquainted with the social determinants of health, and we were encour-
aged by authorities such as Smith, Bambra, and Hill (2016) who
suggested that, since health inequities were linked to matters of social
justice, those with expertise in psychology had a responsibility to both ask,
and address, political questions related to the factors and circumstances
responsible for the presence of psychosocial stressors.
Our initial learnings, however, as we entered the inequity area, puzzled
us. We were interested, but not astonished, at the reported link between
income inequity and population health (e.g. Babones, 2008; Smith et al.,
2016). The negative relationship between these two variables has been
a topic of scientific enquiry since at least the mid-1970s (Baek & Kim,
2018). We were surprised, however, by some of the claims that were
made about the extent to which inequity, primarily income inequity,
made people status conscious, raised stress levels, and created a multi-
plicity of psychological and social problems (e.g., Wilkinson & Pickett,
2010). These problems extended to serious matters including murder
and violence. Apparently, the greater the income inequity of a devel-
oped nation—that is, the wider the gap between those with the most
money and those with the least—the more serious we can expect indi-
vidual problems of not only physical, but also social and psychological
functioning, to be. According to leaders in this area, these problems affect
not only the poor, but also those who are wealthy (Wilkinson & Pickett,
2018). Moreover, people from different countries in similar categories of
education, social class, or income do better in those countries where the
income differential gap is narrower rather than in countries where it is
 1 BEGINNING THE SEARCH FOR ANSWERS 3

wider (Wilkinson & Pickett, 2010). So, a high-income earner in a more

income-equal country will enjoy better physical, psychological, and social
functioning than a person with a similar income in a less income-equal
country (Wilkinson & Pickett, 2010).
Although the literature we initially encountered was supported by
empirical evidence, it didn’t fit with our clinical, research, or other profes-
sional experience. The distressed people we worked with didn’t generally
describe their angst in terms of the things identified as distressing in the
inequity literature. Our clients, for example, seemed to be bothered by
matters other than the fact that the car in their neighbour’s garage cost
more than theirs, or that the size of their plasma screen TV seemed puny
compared to the one owned by the family who just moved in across the
road.
Because our new learning didn’t map easily onto our experiences, we
continued to explore. We were sure there was something, or some things,
we were missing or weren’t understanding, and we wanted to resolve our
confusion. This book is the result of that quest.
Fundamentally, we were baffled. The importance of income inequity,
for example, has led some world leaders to describe it as the defining
challenge of our time and the root of social problems (Gilbert, 2016;
Wilkinson & Pickett, 2017). Why is inequity the problem it is portrayed
to be? To state it more clearly, the two fundamental questions that guided
our interrogation of the literature and most of our discussions on this
topic were:

1. Why is inequity necessarily a problem?

and
2. Why has it been so difficult to resolve?

One thing was clear to us by now. The problem was definitely not due to
a lack of resources. The problem, primarily, seemed to be one of distri-
bution. Hickel (2017, p. 47), for example, points out that “Hunger is
not a problem of lack. It is a problem of distribution. A disproportionate
amount of the world’s food ends up flowing to rich countries, where
much of it ends up as waste.” According to Hickel (2017), enough food
is produced each year so that every global citizen could consume 3000
calories daily.
4 T. A. CAREY ET AL.

So, why should it matter if the person in the apartment across the hall
earns more than you, or if other parents from your child’s class go abroad
for their holidays? Are we really that fickle as a species that we can become
psychologically and socially debilitated, as well as seriously compromised
by life-threatening physical health conditions, at the idea of people doing
better than us? And if that’s the case, why is it apparently so much worse
in societies where those with the least money, and those with the most
money, are a long way apart? Do people in a given society have any idea
of the incomes of their poorest and richest residents?
To help us resolve our growing sense of bewilderment, we constructed
a table to think through some of the information we encountered (see
Table 1.1). In simplistic terms, our understanding of the general idea
being communicated is that, in countries where there is a large differ-
ence between the richest and the poorest, and particularly in developed
countries, there is a raft of serious physical, psychological, and social prob-
lems that affect everyone on the income continuum, from the ones at the
very bottom to those at the pinnacle. In countries where the difference
between the richest and the poorest is not so great, there are fewer prob-
lems. Since a lot of the research seems to draw a distinction between
the developed and developing nations, for the purpose of this thought
exercise, we focus on developed countries.
The conclusions we reached as we mulled over these ideas were that
health and social living in Country A (see Table 1.1) would be much
worse than in Countries B and C, because Country A has startling income
inequity compared with the other two countries (14 compared with 3 on
the fictitious scale we are using for the point of this exercise). Health and

Table 1.1 An illustration of the way in which income inequities could manifest
in different developed countries
*Income Units Income
Income
Country Inequity
Inequity Poorest Richest Measure
High A 1 15 14
B 2 5 3
Low
C 9 12 3
*These are hypothe cal income units for the purpose of
illustra on with lower numbers indica ng less income, and higher
numbers indica ng greater income.
 1 BEGINNING THE SEARCH FOR ANSWERS 5

social living in Countries B and C, however, would be similar because

they have the same level of income inequity even though they have very
different average income levels. Moreover, the health and social func-
tioning of people from Country A who have 12 units of income would
be worse than people in Country C with the same 12 units of income,
because they are situated within a country with high income inequity and,
apparently, relative, rather than absolute income, is what is important.
Seemingly, when groups of people with the same income are compared,
people do worse in less equal societies compared to more equal societies
(Wilkinson & Pickett, 2010). Similarly, the health and social functioning
of someone in Country B with 3 units of income would be better than
the health and social functioning of someone in Country A with 3 units
of income (see Table 1.1).
This reasoning didn’t make sense to us. We continued to entertain
the idea that we were misunderstanding the literature and unintention-
ally building straw men which we could subsequently knock down. The
more we read, however, the more our initial assumptions seemed to be
confirmed.
Before going any further, we should comment on the terms inequity
and inequality. Efforts have been made in some places to draw a distinc-
tion between the terms. Arcaya, Arcaya, and Subramanian (2015, p. 2),
for example, explain:

The key distinction between the terms inequality and inequity is that the
former is simply a dimensional description employed whenever quantities
are unequal, while the latter requires passing a moral judgment that the
inequality is wrong.

Some of the most high-profile writers in this area, however, appear to

frame problems in terms of inequality, rather than inequity (Marmot,
2015; Wilkinson & Pickett, 2010). Smith et al. (2016) suggest that, in
different contexts, different terms are used to refer to the same thing.
Specifically, they offer that in the US and Canada the term “health dispari-
ties” is used while in low- and middle-income countries (LMICs) the term
“health inequities” is preferred (Smith et al., 2016). For the purposes of
this book, we use “health inequity” because that seemed to us to be the
most commonly used term in the literature.
6 T. A. CAREY ET AL.

A Bias Towards Understanding How People Work

One other thing you should know about us at the beginning of this book
is that we all share an abiding interest in understanding how people work.
We use the term “work” here in the sense of how our bodies do what
they do to continually create the lives we live, not in the occupational
sense of building a career or earning enough money to make ends meet.
Appreciating the mechanics and necessary processes that allow people to
navigate their days, the factors that enable them to thrive, and all the
things that can compromise that flourishing are some of the favourite
things we like to discuss, research, teach, and write about, as well as apply
in our clinical practice. We will provide a lot more detail about these ideas
in Chapter 3. And, in fact, the majority of this book is the culmination
of where our myriad queries, conversations, and cogitations took us, as
we discovered, then pondered, the various inequity ideas in the context
of our primary preference for understanding how humans work.

A Lack of Agreement in the Field

To find a way out of the conceptual labyrinth in which we had become
ensnared, we read widely, and discussed and debated the various find-
ings we encountered. Before too long, we were struck by the general
lack of consensus in the field. While almost everyone agrees that inequity
is counterproductive—although even here some people think a certain
amount of inequity is inevitable with the important issues being how
it comes about and how much is acceptable (Gilbert, 2016; Marmot,
2015; OECD, 2008)—beyond this general level of agreement, there are
rampant differences of opinion.

Could Perspective Be Part of the Problem?

As our learning continued, it became more and more apparent, that the
current prevailing perspective might be as much of a problem as any
particular method or research finding in the inequity realm. It seemed
like something similar to the story of the “blind men and the elephant”
might be occurring. We were also reminded of the difficulties confronted
by the geocentric astronomers of centuries past as they tried to improve
the accuracy of their models of celestial bodies circling the earth. The
relevance here was that problems that arose were not due to limitations
 1 BEGINNING THE SEARCH FOR ANSWERS 7

in the capabilities of the astronomers or the equipment at their disposal.

The problem was perspective. It was the astronomers’ frame of reference
that needed altering, not the methods they used, or the way they used
them. Once a heliocentric model of the solar system became accepted,
the problems inherent in the geocentric perspective became redundant,
and different questions required answering.
We wondered if something similar was occurring in the inequity field.
As we continued to search for answers, we applied our understanding
of human functioning to all that we encountered. In this book, therefore,
we don’t aim to provide answers as much as we’d like to table a possible
constructive direction in which innovative, original questions could be
formulated to yield novel answers. We’re wondering, if it would make a
difference to the way in which inequity is understood, investigated, and
addressed, if human nature was considered this way, rather than from the
current prevailing perspective. The information in this book is a detailed
explanation and analysis of this applied to inequity.
We openly acknowledge our newness to the health inequity field and
our lack of recognised authority in this area. A fresh and unfamiliar
approach, however, could be considered an advantage. With backgrounds
in psychological knowledge and research, and an understanding of the
way in which individuals function as purposive agents embedded in social
environments, we have been able to consider the work in this area in ways
that might, ultimately, be considered unconventionally constructive. It is
this unfamiliar point of view that we’re suggesting could offer an alterna-
tive and useful approach to people who are looking for different options
in addressing problems of inequity.

Sharing Our Journey

For the remainder of this chapter we’ll highlight, generally, the main ideas
we’ve discovered in the health inequity domain. In the next chapter,
we’ll provide a little more detail of some of the places in which there
seems to be a generous dollop of disharmony. These two early chap-
ters are provided to set a context, and to indicate where some of the
main divisions exist. Our purpose in writing this book was not to chron-
icle in a fine-grained way all that has been done and is known in the
inequity terrain. Rather, we’d like to provide enough information for
you to judge for yourself the soundness (or otherwise) of our reasoning.
We also wanted to justify why we thought a renovation of the area was
8 T. A. CAREY ET AL.

warranted, so that we could then describe some of the possibilities for

where a new approach might lead.
In Chapter 3 we introduce our understanding of how people func-
tion. Chapter 4 explores the implications of this understanding for the
way in which we define health. In Chapters 5 and 6 we spend time
looking closely at the research strategies and tactics that define the
inequity domain in terms of concepts such as causality and statistical
significance and we provide some alternative ideas. Chapter 7 takes a case
study approach with one important paper to demonstrate that many of
the field’s findings are not wrong as much as they are incomplete. In
Chapter 8 we turn our gaze from research to practice and outline some
of the ways our ideas might inform current approaches to healthcare and
the associated practices.
To conclude the book in a way that we could be satisfied with, we
wanted to do as much as we could to answer the important “so what?”
question. So, in Chapter 9, the final chapter, we stretch our wonderings
a little further. We don’t think we ever stray into the ludicrous or the
implausible but that might not be our judgement to make.
So, now that you have a sense of what lies ahead, let’s get down to
business …
Before we can sensibly discuss where an alternative present time could
be and what it might look like, however, it is important to appreciate
the state of our current present time with regard to health inequity. It is
to the task of providing our general impression of the existing state of
knowledge to which we now turn.

The Link Between Income

Inequity and Health Outcomes
While the characteristics of a contented life, and what promotes and
impedes it, have interested us for the longest time, we think of our reading
about the link between income inequity and a plethora of psycholog-
ical and social problems as the place where this particular part of our
journey began. It was some of this work that perplexed us, and created the
quandary we found ourselves in, so this is perhaps the most appropriate
place to commence an overview of the field.
 1 BEGINNING THE SEARCH FOR ANSWERS 9

The Main Point and Some Nuances of Which to Be Aware

The general idea being conveyed by proponents of the position that
income inequity and physical, psychological, and social functioning are
tightly linked, is that the way we relate to each other on a societal
level is strongly influenced by the scale of the income differences of that
society (Wilkinson & Pickett, 2010). Apparently, within any particular
country, people’s health and happiness are related to their income such
that wealthy people, on average, are healthier and happier than poor
people (Wilkinson & Pickett, 2010).
There are at least four qualifiers which are essential to be aware of
in order to appreciate the scope of this research. First, these findings
apply only to more affluent countries. It appears that economic devel-
opment is important for well-being in poorer countries but, as countries
join the ranks of the well-to-do, economic development becomes less
and less relevant to well-being (Smith et al., 2016; Wilkinson & Pickett,
2010, 2018). Bartley (2017), however, introduces an important nuance
here related to the health of an individual and the health of society.
Beyond a certain average income, increases in this income do not seem
to improve the health of that society. The health of an individual within a
country, however, does seem to be better if they enjoy more prestige and
favourable employment conditions (Bartley, 2017).
Second, some researchers contend that it is the magnitude of income
inequity which is important, not a wealthy country’s average income
(Wilkinson & Pickett, 2010). Apparently, the same effect is found in
affluent countries with greater or lesser average income, such that phys-
ical, psychological, and social functioning are only weakly related to a
rich country’s average income (Wilkinson & Pickett, 2010). Even here,
however, there are important caveats since Curran and Mahutga’s (2018)
work indicates that income inequity impacts most detrimentally on the
population health of the least developed countries with no significantly
harmful impact in high-income countries.
Third, the link between income inequity and different aspects of daily
functioning is most strongly found when comparisons occur on larger
scales such as countries, states, or regions (Pickett & Wilkinson, 2010).
The link is not as obvious or robust when small local areas and communi-
ties are considered. Pickett and Wilkinson (2015) report that variations
in geographical scale between different studies are a methodological
consideration that influences the outcomes of those studies. When larger
10 T. A. CAREY ET AL.

jurisdictions are investigated, income inequity can be considered to be an

indicator of the extent of social stratification, or hierarchicalisation, that
exists and, in this context, the link between income inequity and health is
generally supported (Pickett & Wilkinson, 2010).
Fourth, even when the link between income inequity and physical,
psychological, and social functioning can be identified, on average, in
wealthier countries, for larger groupings of people, it only applies to
aspects of functioning that have strong social class gradients (Wilkinson &
Pickett, 2010). Apparently, cardiovascular disease and crime are included,
but breast and prostate cancer are not (Wilkinson & Pickett, 2017). If you
are wondering, at this point, why some problems in functioning might
exhibit what are called social gradients, while others do not, you will
have taken a little step into the world we experienced as mystifying as
we plunged into this work.

A Closer Look at the Findings

Having established some of the parameters to the scope of this research,
we can consider in more detail key findings from the literature. Wilkinson
and Pickett (2010) are among a number of researchers who convey a
strong interest in the social impact of income inequity. Table 1.2 provides
examples from the literature of different researchers and the ways in
which they report income inequity impacting on physical, psycholog-
ical, and social functioning. When they measure income inequity, for
example, they assert that they are actually measuring indicators of the
degree to which a society is hierarchicalised such as social distance and
social stratification. The hierarchy is important because disparities in
those aspects of functioning that are affected by a social gradient impact
not only on the poor, but also on the wealthy. Those who are only
reasonably well-off, for example, have shorter lives than those who are
extremely wealthy (Wilkinson & Pickett, 2010). The gradient effect only
emerges, however, when group, rather than individual, data are consid-
ered. Without that qualifier, one could reasonably expect from Wilkinson
and Pickett’s (2010) findings that the oldest person in any given (affluent)
society would be the wealthiest and, similarly, that the person at the top of
the money pile would live to be the oldest member of that society. With
that detail clarified, the conclusion that inequity has effects throughout
society, not just for poor people, is emphasised in a number of sources
(Wilkinson & Pickett, 2010, 2018).
 1 BEGINNING THE SEARCH FOR ANSWERS 11

Table 1.2 Examples from the literature of aspects of physical, psychological,

and social functioning that are reported to be linked to income inequity
Source Different Features of Func oning
Babones, 2008 Life expectancy; infant mortality; murder rates; popula on health
Baek & Kim, 2018 Infant mortality
Bartley, 2017 Unemployment benefits; public health services; educa on; housing;
transport; life expectancy; social pathology; compe on and coopera on;
trust; criminal behavior; pollu on; traffic hazards
Bezruchka, 2014 Mortality levels; infant death rates
Curran & Mahutga, 2018 Popula on health
Frank, 2014 Bankruptcy rates; divorce rates; commute mes
Kragten & Rozer, 2017 Life expectancy; self-rated health; social trust
Marmot, 2015 Social cohesion; economic growth
OECD, 2008 Social mobility; poli cal influence of the wealthy; economic performance;
capacity to act collec vely; health outcomes; educa onal outcomes
OECD, 2011 Social mobility; opportunity; poli cal stability; economic performance
Patel et al., 2018 Mental health
Picke & Wilkinson, 2010 Mental illness; physical health; trust; violence
Picke & Wilkinson, 2015 Life expectancy; mental illness; obesity; infant mortality; teenage births;
homicides; imprisonment; educa onal a ainment; distrust; social mobility
Schneider, 2019 Life sa sfac on; subjec ve social status; wellbeing
Smith et al., 2016 Health; mortality; environmental issues
S glitz, 2012 Educa onal opportunity; nutri on; exposure to environmental pollutants
Wilkinson, 2014 Death rates; health; obesity; infant death rates
Wilkinson & Picke , 2010 Child wellbeing; women’s obesity (the link is not as strong for men’s obesity);
health; status compe on and status anxiety; trust; mental illness in adult
women (but not adult men); use of illegal drugs such as cocaine, marijuana,
and heroin; death from heart disease; deaths from homicide; illness; status
insecurity; violence; divorce rates; children’s aspira ons (higher in unequal
countries)
Wilkinson & Picke , 2017 Life expectancy; mortality rates; life chances and trajectories of childhood;
mental health
Wilkinson & Picke , 2018 Life expectancy; infant mortality; mental illness; illicit drug use (including
heroin, cocaine, amphetamines); obesity; violence (measured by homicide
rates – adult and juvenile); imprisonment; trust; community life; child
wellbeing; educa onal a ainment; teenage births; social mobility; status
anxiety; worries about being judged; depression; psycho c symptoms;
schizophrenia; narcissis c traits; alcohol consump on; self-esteem;
confidence; educa onal standards; par cipa on in the arts; propor on of the
labour force employed in guard labour (security staff, police, prison officers);
lower produc vity
12 T. A. CAREY ET AL.

Explaining Why Income Inequity Might Have the Effect That It Does
While we were intrigued about the extent of the reported association
between income inequity and physical, psychological, and social func-
tioning, we were especially surprised at the explanations given for this
relationship. Wilkinson and Pickett (2018, p. xxi), for example, argue
that “if well-educated people with good jobs and incomes lived with the
same jobs and incomes in a more equal society, they would be likely to
live a little longer and less likely to become victims of violence; their
children might do a little better at school and would be less likely to
become teenage parents or to develop serious drug problems”. This is
an example of the reasoning we were depicting in Table 1.1. Wilkinson
and Pickett (2018, p. xxi) go on to suggest that the issue is “the way
larger income differences across a society immerse everyone more deeply
in issues of status competition and hierarchy”. They explain that “these
problems are driven by the stress of social status differences themselves,
stresses which get worse the lower you are on the social ladder and the
bigger the status differences. In effect, bigger income differences make
status differences more potent” (Wilkinson & Pickett, 2018, p. xxii). In
the same source, Wilkinson and Pickett (2018, p. 25) clarify their posi-
tion by suggesting that although “low incomes limit what poorer people
can buy, they leave status aspirations undiminished – or even heightened
– by the desire to escape the stigma of low social status”. They also
link extreme shyness, which they acknowledge can be diagnosed as social
phobia or social anxiety disorder, to income inequity, and they report that
the prevalence of people diagnosed with social anxiety disorder in the
US has increased over three decades from 2% to 12% of the population
(Wilkinson & Pickett, 2018).
It was perhaps our familiarity with the mental health field that indi-
cated to us that there might be something amiss with the explanatory
conclusions being drawn in the inequity arena. There is, in fact, a volumi-
nous literature outlining the many different problems with the Western
biomedical approach to understanding psychological and social func-
tioning as it is described in the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM 5; American Psychiatric
Association, APA, 2013). Timimi (2014) provides an excellent overview
of some of the major problems. Social phobia was created and first
introduced into the DSM system in its third edition in 1980 (Whitaker
& Cosgrove, 2015). There is compelling evidence that the explosion
 1 BEGINNING THE SEARCH FOR ANSWERS 13

in the identification and diagnosis of this manufactured disorder has

far less to do with income inequity than with the monstrously enthu-
siastic (some would say aggressive) and sustained promotion of the
disorder, and marketing of pharmaceutical treatments by the APA and
the pharmaceutical industry (Whitaker & Cosgrove, 2015).
There are other reasons one might question the extent to which
everyone in a society characterised by large income differences is stress-
fully consumed by status competition leading to increases in social phobia
or social anxiety disorder diagnoses. Perhaps the preferences and patterns
of media use by populations have something to offer here. The televi-
sion show Lifestyles of the Rich and Famous, for example, screened from
1984 to 1995. It has been described as ushering in a new era of television
programmes that brought the wealthiest people into our living rooms and
paraded their lifestyles and living quarters before us. Lifestyles had spin-
off programmes, a board game, and a video slot machine generated from
its success. Would large numbers of people tune into Lifestyles, and the
later shows it spawned, if they were all wracked with anxiety by the very
same status differences each episode of these programmes ostentatiously
flaunted? It is difficult to reconcile this suggested population-level self-
torture with our understanding of Western life in the 1980s and 1990s.
Also, some popstars have enormous followings on social media such as
Twitter and Instagram. Shakira and Britney Spears, for example, have
more than 50 million Twitter followers, while Justin Timberlake has more
than 60 million followers. Kim Kardashian has, reportedly, 157 million
followers on Instagram. We are certainly not oblivious to the problems
social media can have for people’s psychological and social functioning.
We are tabling, however, the possibility that gaping financial and status
differences might not be the widespread scourges they are sometimes
reported to be, and that, in fact, some people might be buoyed rather
than bothered by the trappings of the ultra-rich.
Gilbert (2016, p. 68) is also sceptical of the way in which the
link between psychological stress and income inequity is explained by
Wilkinson and Pickett (2010, p. 43) and refers to their suggestion as
“flimsy speculation”. To compound our confusion, the supposed associ-
ation between psychological functioning and income inequity conflicted
with other reports in the literature including Wilkinson and Pickett’s later
research. For example, Wilkinson and Pickett (2018) maintained that a
consistent finding in their research was a strong tendency for people to
compare themselves with others who were similar to them, such as work
14 T. A. CAREY ET AL.

colleagues, not with people who were far away on the social ladder. To
the extent that people engage in social comparisons at all, if they only
compare themselves to those with whom they are similar, we could not
understand the significance of a wide income gap. Perhaps part of the
problem here is the application of findings obtained from population level
data to individual lives.

Alternative Views About the Research

Despite the volume of research indicating a strong link between income
inequity and a range of problems with physical, psychological, and social
functioning, the robustness of this connection continues to be ques-
tioned. Schneider (2019), for example, describes the research findings
regarding the link between income inequity and well-being as inconsis-
tent, and indicates that the consequences of income inequity might not
be as straightforward as is often reported. Smith et al. (2016) also report
that the empirical basis for psychosocial explanations of the link between
inequity and health have been challenged. Rozer, Kraaycamp, and Huijts
(2016) empirically tested the hypothesised link between income inequity
and health and found no significant relationship between national income
inequity and self-rated health.
Bartley (2017) describes the amount of disagreement regarding the
relationship between income inequity and health as “considerable”.
Furthermore, even when there is agreement regarding the relationship
between income inequity and health, there is frequently concurrent
disagreement about why this might be so (Bartley, 2017). Marmot (2015)
also contends that the evidence indicating that income inequities are bad
for health is weaker now than it once was. Perhaps the disagreement
exists because, whatever relationship there is between income inequity
and health, it is not particularly strong. Babones (2008) refers to Beck-
field’s (2004) earlier work that produced from a comprehensive study,
a correlation between population health and income inequity of −0.31.
Although this correlation was reported as highly statistically significant, a
coefficient of this size does not indicate a strong relationship. It is often
helpful to visualise what different correlations look like. In Fig. 1.1, we
have created a scatterplot of a correlation of −0.31 between two vari-
ables, “x” and “y”. In this instance “x” could be a measure of income
inequity such as the Gini coefficient (a widely used measure of inequity
Another random document with
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"And why not to-night as well as any time?" questioned Mrs. Morgan in a half-
vexed tone, as one who was fully prepared to combat sentiment or folly of any
sort that might have arisen in her daughter's mind. But the daughter only
answered, "Oh, I don't know!" and snuffed the candle again; and the darning-
needle gleamed back and forth in the candle-glow, and no sound broke the
stillness for the next ten minutes.

The other furnishings of the room can be briefly given. A square stand in the
corner held the "Farmer's Companion," a weekly paper highly prized; a small
copy of "Webster," very much abridged, and with one cover gone. A tack in
the wall, over the stand, held the "Farmer's Almanac;" and near it a
pasteboard case, somewhat gaily decorated with fancy pictures, held the
family hairbrush and comb. The great stove, capable of taking in large pieces
of wood at a time, was aglow, both with fire-light and with polish, and was
really the only bright and pleasant thing in the room. The floor was painted a
good, clear yellow, and was guiltless of even a rug to relieve its bareness.

Behind the stove, with his feet on the hearth, and his slouched hat pushed on
the back of his head, and his pants tucked carefully into his barn-yard boots,
sat the younger son of the family, John Morgan, his hands in his pockets, and
his eyes fixed somewhat gloomily on the fire. Just across from him, occupying
the other corner of the fireplace, was the father of the family, a prematurely
old, bent man. His gray hair stood in disorder on his head—"stood" being the
exact word to apply to it, as even vigorous brushing never coaxed it into
quietness for any length of time. He was tilted slightly back in his straight-
backed wooden arm-chair, which boasted of a patchwork cushion, and was
the only bit of luxury that the room contained. A few chairs, yellow painted like
the floor, wooden-bottomed, keeping themselves in orderly condition in the
three unoccupied corners of the room, completed its furnishings—unless a
shelf at the back of the stove, and in somewhat alarming proximity to the
aforesaid barn-yard boots, where a row of milk-pans were stationed waiting for
the cream to "set," and a line on which hung certain towels used in cleansing
and drying the pans, and a hook at a little distance holding the family hand-
towel, can be called furnishings.

Sundry other hooks were empty—the sixteen-year-old daughter having taken

counsel with herself for a little, and then quietly removed two coats and a pair
of overalls to the back kitchen closet.

A door leading into the small, square, bare-floored bedroom of Jacob Morgan
and his wife stood open, and revealed the six-year-old baby of the family, fair-
haired, soft-eyed Nellie Morgan, her eyes at this time being wide-open and
aglow with an excitement which she could not control. But for the solemn rule
that seven o'clock must find her in bed, whether the town three miles away
was on fire, or whatever was happening, she would have begged to stay out
of that trundle-bed, on this particular evening, just one hour more.

John Morgan winked and blinked, and nodded assent to his dream-thoughts
with his mouth wide-open, then came down on the four legs of his chair with a
sudden thud that made him wide-awake and rather cross. He looked at the
tall, loud-voiced old clock in the corner, which was certainly part of the
furniture, and the most important part; it is strange I should have forgotten it.
At this moment it was making up its mind to announce the advent of the next
hour.

"It seems a pity that Lewis couldn't have got around at a little more
seasonable hour," Farmer Morgan said at last, rubbing his eyes and yawning
heavily, and gazing at the solemn-faced clock. "I can't see why he couldn't just
as well have taken an earlier train and got here this afternoon. It will be
getting-up time before we fairly go to bed."

"I don't see any occasion for being very late to bed," Mrs. Morgan said; and
she drove the gleaming needle through the sock as though she were vexed at
the yawning hole. "We needn't sit up till morning to talk, there will be time
enough for that; and so long as Lewis went to the expense of getting supper
at the village, we won't have to be hindered on that account."

"I'm most awful glad he did," interposed the candle-snuffer. "I couldn't bear to
think of getting supper and washing dishes right before her."

"I wonder why not? She most likely has been used to dishes, and she knows
they have to be washed. It isn't worth while to go to putting on airs before her
so long as you can't keep them on. The dishes will probably have to be
washed three times a day, just as they always have been. Because Lewis has
got married the world isn't going to stop turning around."

How fast the darning-needle slipped through the hole, shrinking it at every turn
and stabbing its sides with great gray threads!

"I most wonder why you didn't put a fire in the front room, being it was the first
night; it would have been less—well, less embarrassing like," the farmer said,
hunting in his brain for the right word and apparently not finding it.

"I don't know as there is any call to be embarrassed," Mrs. Morgan said, and
the furrows in her face seemed to grow deeper. "I thought it was best to begin
as we meant to end; and I didn't s'pose we would be likely to have fires in the
front room of evenings now any more than we have had. This room has
always been large enough and good enough for Lewis, and I suppose we can
make a place for one more."

But she looked that moment as though the "one more" were a sore trial to her,
which she endured simply because she must, and out of which she saw no
gleam of comfort.

During this family discussion, John Morgan kept his feet in their elevated
position on the upper hearth, and continued his steady, gloomy gaze into the
fire. He was a young man, not yet twenty, but already his face looked not only
gloomy but spiritless. It was not in every sense a good face; there were lines
of sullenness upon it, and there were lines which, even thus early, might have
been born of dissipation. Mrs. Morgan had been heard to say many a time
that Lewis was a good boy, had always been a good boy, but who John took
after she could not imagine; he was not a bit like the Morgans, and she was
sure he did not favour her side of the house.

But, truth to tell, Lewis Morgan had at last disappointed his mother. Of course,
he would get married some time—it was the way with young men; but he was
still quite a young man, and she had hoped that he would wait a few years.
And then she had hoped that, when the fatal day did come, he would choose
one of the good, sensible, hard-working farmers' girls with which the country
abounded, any one of whom would have esteemed it an honour to be
connected with the Morgan family.

But to go to town for a wife, and then to plunge right into the midst of
aristocracy, and actually bring away a daughter of Lyman Barrows, whose
father once occupied a high position in the Government! Mrs. Morgan felt
aggrieved. Farmers and farmers' wives and daughters had always been good
enough for her; why were they not for her son?

This matter of family pride is a very queer thing to deal with. I doubt if you will
not find it as strongly developed among the thrifty and intelligent classes of
farmers as anywhere in this country. To be sure, there are different
manifestations of pride. Assuredly Mrs. Morgan knew how to manifest hers.

"There they come!" declared the candle-snuffer; and her face grew red, and
she dropped the snuffers into the tray with a bang. It was just as the old clock
had made up its mind to speak, and it solemnly tolled out eight strokes.

"Dorothy!" said she of the darning-needle, severely. "I am ashamed of you.

There is no occasion for you going into hysterics if they have come."
The feet on the upper hearth came down on the brick hearth with a louder
bang than the snuffers had made. "I'm going to the barn," said their owner
promptly. "Lewis will want to have his horse took care of; and I don't want to
see none of 'em to-night. You needn't call me in, for I ain't coming."

And he dodged out at the back door just as the front one opened, and a
shoving of trunks sounded on the oil-cloth floor of the great old-fashioned hall,
and Lewis Morgan's voice said cheerily, "Where are you all?" and the mother
rolled up the stocking, and stabbed it with the darning-needle, and shook out
her check apron, and stood up to give them greeting; and Louise Morgan had
reached her home.

CHAPTER III.
INTRODUCED.

Now Louise, despite all her previous knowledge of the Morgan family, had
done just as people are always doing—planned their reception at the old
homestead quite after the manner of life to which she had been accustomed,
instead of arranging things from the Morgan standpoint. In imagination, she
had seen her husband folded in his mother's arms, his bearded face covered
with motherly kisses. "It is not reasonable to suppose that she will care to kiss
me," she had said to herself, "but I will give her one little, quiet kiss, to show
her how dear Lewis's mother is to me, and then I will keep myself in the
background for the first evening. They will be so glad to get Lewis back that
they will not have room for much notice of me."

Kisses! Hardly anything could be more foreign to Mother Morgan's life than
those. It was actually years since she had kissed her grown-up son. She held
out her hard old hand to him, and her heart beat quickly, and she felt a curious
tremble all over her that she would have been ashamed to own, but with a
mighty effort she controlled her voice, and said—
"Well, so you have got back safe, with all your rampaging around the world; I
should think you had had enough of it. And this is your wife?"

And then Louise had felt the quick grasp and release of her hand, and had not
realized the heart-beats; and Lewis had shaken hands with his father and his
sister Dorothy, and had said—

"Father, this is my wife."

And the premature old man, with the premature gray hairs standing up over
his head, had nodded to her, without even a hand-clasp, and said—

"I'm glad you are safe at home. You must be tired out; travelling is worse than
ploughing all day. I never could see why folks who hadn't got to do it should
take journeys."

And this was the home-coming! Two nights before, they had been in the old
home, stopping there over night, after a two weeks' absence in another
direction. How the mother had clasped her to her heart and cried over her!
How the father had called her his "precious daughter," and wondered, with a
quiver in his lips and a tremble in his voice, how they could let her go again!
How Estelle—bright, beautiful, foolish Estelle—had hugged and caressed and
rejoiced over her darling sister! What a contrast it was! It all came over her just
then, standing alone in the centre of that yellow painted floor—the
tremendous, the far-reaching, the ever-developing contrast between the home
that had vanished from her sight and the new home to which she had come.
She felt a strange, choking sensation, as if a hand were grasping at her throat;
the dim light in the tallow candle gleamed and divided itself into many sparks,
and seemed swinging in space; and but for a strong and resolute
determination to do no such thing, the bride would have made her advent into
the Morgan household a thing of vivid memory, by fainting away!

"Lewis!" called a soft, timid voice from somewhere in the darkness. Looking
out at them from that bedroom door, poor little Nellie, with her shining eyes
and her beating heart, could endure it no longer; and although frightened at
her boldness, and dipping her yellow head under the sheet the minute the
word was out, she had yet spoken that one low, eager word.

"O Nellie!" Lewis had exclaimed. "Are you awake? Louise, come and see
Nellie."

Indeed she would; nothing in life looked so inviting to his young wife at that
moment as the darkness and comparative solitude of that inner room. But
Lewis had seized the tallow candle as he went—Dorothy, meantime, having
roused sufficiently to produce another one; and as Louise followed him she
caught a glimpse of the shining eyes and the yellow curls. A whole torrent of
pent-up longing for home and love and tenderness flowed out in the kisses
which were suddenly lavished on astonished little Nellie, as Louise nestled her
head in the bed-clothes and gathered the child to her arms.

"She looks like you, Lewis," was the only comment she made; and Lewis
laughed and flushed like a girl, and told his wife she was growing alarmingly
complimentary; and Nellie looked from one to the other of them with great,
earnest, soulful eyes, and whispered to Lewis that she "loved her almost as
much as she did him!" with a long-drawn breath on the word "almost" that
showed the magnitude of the offering at the shrine of his new wife. On the
whole, it was Nellie that sweetened the memory of the home-coming, and
stayed the tears that might have wet Louise Morgan's pillow that night.

As for John, he stayed in the barn, as he had planned, until the new-comers
were fairly out of sight above stairs.

"He is a queer fellow," explained Lewis to his wife, as they went about their
own room. "I hardly know how to take him. I don't think I have ever understood
his character; I doubt if anybody does. He is pent-up; there is no getting at his
likes or dislikes, and yet he has strong feelings. He has given my father a
good many anxious hours already; and sometimes I fear there are many more
in store for him from the same source."

And Lewis sighed. Already the burden of home life was dropping on him.

Louise was by this time so divided between the sense of loneliness that
possessed her and the sense of curiosity over every article in and about her
room, that she could not give to John the interest which the subject
demanded. It was utterly unlike any room that she had ever seen before. A
brilliant carpet, aglow with alternate stripes of red and green, covered the
floor. Louise looked at it with mingled feelings of curiosity and wonder. How
had it been made, and where? How did it happen that she had never seen a
like pattern before? It did not occur to her that it was home-made; and if it had,
she would not have understood the term. The two windows to the room were
shaded with blue paper, partly rolled, and tied with red cord. There was a
wood fire burning in a stove, which snapped, and glowed, and lighted up the
strange colours and fantastic figures of the wall-paper; there were two or three
old-fashioned chairs, comfortable, as all old-fashioned chairs are; and there
was a high-post bedstead, curtained at its base by what Louise learned to
know was a "valance," though what its name or use she could not on this
evening have told. The bed itself was a marvel of height; it looked to the
bewildered eyes of the bride as though they might need the services of a step-
ladder to mount it; and it was covered with a tulip bed-quilt! This also was
knowledge acquired at a later date. What the strangely-shaped masses of
colour were intended to represent she had not the slightest idea. There was a
very simple toilet-table, neatly covered with a towel, and its appointments
were the simplest and commonest. A high, wide, deep-drawered bureau, and
a pine-framed mirror, perhaps a foot wide and less than two feet long,
completed the furnishings, save a couple of patchwork footstools under the
windows.

Lewis set down the candlestick, which he had been holding aloft, on the little
toilet-table, and surveyed his wife with a curious, half-laughing air, behind
which was hidden an anxious, questioning gaze.

"My mother has an intense horror of the new invention known as kerosene,"
was his first explanatory sentence, with a comical side glance toward the
blinking candle.

"Kerosene!" said Louise absently, her thoughts in such confusion that she
could not pick them out and answer clearly. "Doesn't she like gas?" And then
the very absurdity of her question brought her back to the present, and she
looked up quickly in her husband's face, and, struggling with the pent-up
tears, burst instead into a low, sweet, ringing laugh, which laugh he joined in
and swelled until the low ceilings might almost have shaken over their mirth.

"Upon my word, I don't know what we are laughing at," he said at last: "but
she is a brave little woman to laugh, and I'm thankful to be able to join her;"
and he pushed one of the patchwork footstools over to where she had sunk
on the other and sat down beside her.

"It is all as different as candle-light from sunlight, isn't it? That blinking little
wretch over there on the stand furnished me with a simile. I haven't done a
thing to this room, mainly because I didn't know what to do. I realized the
absurdity of trying to put city life into it, and I didn't know how to put anything
into it; I thought you would. In fact, I don't know but it fits country life. It has
always seemed to me to be a nice, pleasant home room, but—well—well, the
simple truth is, Louise, there is something the matter with it all, now that you
are in it,—it doesn't fit you; but you will know how to repair it, will you not?" An
anxious look was in his eyes, there was almost a tremble in his voice, the
laughter had gone out of them so soon. It nerved Louise to bravery.
"We will not rearrange anything to-night," she said brightly; "we are too tired
for planning. That great bed is the most comfortable thing I can think of; if we
can only manage to get into it. What makes it so high, Lewis?"

Whereupon he laughed again, and she joined, laughing in that immoderate,

nervous way in which people indicate that the laughter, hilarious as it appears,
is but one remove from tears. And it was thus that the first evening under the
new home-roof was spent.

John, coming from his hiding-place and going in stocking feet up the stairs,
heard the outburst, and, curling his sour-looking lip, muttered: "They feel very
fine over it; I hope it will last."

And the poor fellow had not the remotest idea that it would. Boy that he was,
John Morgan was at war with life: he believed that it had ill-treated him; that to
his fortunate elder brother had fallen all the joy, and to him all the bitterness.
He was jealous because of the joy. He was not sure but he almost hated his
brother's wife. Her low, clear laugh, as it rang out to him, sounded like
mockery: he could almost make his warped nature believe that she was
laughing at him, though she had never seen, perhaps never heard of him. If
she had seen his face at that moment, doubtless her thoughts would have
been of him; as it was, they revolved around the Morgan family.

"What about your sister Dorothy?" she asked her husband, diving into the
bewilderments of the large trunk, in search of her toilet case.

"Dorothy is a good, warm-hearted girl, who has no—well—" and then he

stopped; he did not know how to finish his sentence. It would not do to say
she had no education, for she had been the best scholar in their country
school, and during her last winter was reported to have learned all that the
master could teach her.

She had been disappointed, it is true, that he had not known more; and Lewis
had been disappointed, because he wanted her to go on, or go elsewhere,
and get—what? He did not know how to name it. Something that his wife had
to her very finger-tips, and something that Dorothy had not a trace of. What
was the name of it? Was it to be learned from books? At least he had wanted
her to try, and she had been willing enough, but Farmer Morgan had not.

"She has book-learning enough for a farmer's daughter," he had said sturdily.
"She knows more about books now than her mother ever did; and if she
makes one-half as capable a woman, she will be ahead of all the women
there are nowadays."
So Dorothy had packed away her books, and settled down at her churning
and baking and dish-washing; she took it quietly, patiently. Lewis did not know
whether the disappointment was very great or not; in truth he knew very little
about her. Of late he had known almost nothing of home, until within the last
year failing health and the necessity for outdoor life had changed all his plans
and nearly all his hopes in life.

Louise waited for a completion of the unfinished sentence, but her husband
seemed unable to add to it. He bent over the valise and gave himself to the
business of unpacking, with a puzzled air, as though he were trying to solve a
problem that eluded him. His wife tried again.

"Lewis, why is she not a Christian?"

Now, indeed, he dropped the coat that he was unrolling, and, rising up, gave
the questioner the full benefit of his troubled eyes. He was under the
impression that he was pretty well acquainted with his wife; yet she certainly
had the fashion of asking the most strange-sounding questions, perplexing to
answer, and yet simple and straightforward enough in their tone.

"Why is it?" he repeated. "I do not know; my dear Louise, how could I know?"

"Well, doesn't it seem strange that a young lady, in this age of the world,
surrounded by Christian influences, should go on year after year without
settling that question?"

Her husband's answer was very thoughtfully given. "It seems exceedingly
strange when I hear you speak of it, but I do not know that I ever thought of it
in that sense before."

Then the unpacking went on in silence for a few minutes, until Louise
interrupted it with another question.

"Lewis, what does she say when you talk with her about these matters? What
line of reasoning does she use?"

It was so long before she received an answer that she turned from her work in
surprise to look at him; then he spoke.

"Louise, I never said a word to her on this subject in my life. And that seems
stranger to you than anything else?" he added at last, his voice low and with
an anxious touch in it.
She smiled on him gently. "It seems a little strange to me, Lewis, I shall have
to own; but I suppose it is different with brothers and sisters from what it is
when two are thrown together constantly as companions. I have no brother,
you know."

Do you know what Lewis thought of then? His brother John.

CHAPTER IV.
FROM DAWN TO DAYLIGHT.

IT was by the light of the blinking tallow candle that they made their toilets
next morning. Louise roused suddenly, not a little startled at what she
supposed were unusual sounds, issuing from all portions of the house, in the
middle of the night.

"Do you suppose any one is sick?" she asked her husband. "There has been
a banging of doors and a good deal of hurrying around for some minutes."

"Oh no," he said, reassuringly. "It is getting-up time. John is a noisy fellow, and
Dorothy can make considerable noise when she undertakes. I suspect they
are trying to rouse us."

"Getting-up time! why, it must be in the middle of the night."

"That depends on whether one lives in town or in the country. I shouldn't be

greatly surprised if breakfast were waiting for us."

"Then let us hurry," said Louise, making a motion to do so; but her husband
remanded her back to her pillow, while he made vigorous efforts to conquer
the old-fashioned stove, and secure some warmth.

"But we ought not to keep them waiting breakfast," Louise said in dismay.
"That is very disagreeable when everything is ready to serve. We have been
annoyed in that way ourselves. Lewis, why didn't you waken me before?
Haven't you heard the sounds of life for a good while?"

"Yes," said Lewis, "longer than I wanted to hear them. If they don't want
breakfast to wait they shouldn't get it ready at such an unearthly hour. There is
no sense in rousing up the household in the night. During the busy season it is
a sort of necessity, and I always succumb to it meekly. But at this date it is just
the outgrowth of a notion, and I have waged a sort of silent war on it for some
time. I suppose I have eaten cold breakfasts about half the time this autumn."

"Cold breakfasts! Didn't your mother keep something warm for you?"

"Not by any manner of means did she. My mother would not consider that she
was doing her duty to her son by winking at his indolent habits in any such
fashion; she believes that it is his sacred duty to eat his breakfast by early
candle-light, and if he sins in that direction it is not for her to smooth the
punishment of the transgressor."

Louise laughed over the serio-comic tone in which this was said, albeit there
was a little feeling of dismay in her heart; these things sounded so new, and
strange, and unmotherly!

"Louise dear, I don't want to dictate the least in the world, and I don't want to
pretend to know more than I do; but isn't that dress just a trifle too stylish for
the country—in the morning, you know?"

This hesitating, doubtful sort of question was put to Mrs. Morgan somewhat
later, after a rapid and apparently unpremeditated toilet.

She gave the speaker the benefit of a flash from a pair of roguish eyes as she
said—

"Part of that sentence is very opportune, Lewis. You are evidently 'pretending
to know more than you do.' This dress was prepared especially for a morning
toilet in the country, and cost just fivepence a yard."

"Is it possible!" he answered, surveying her from head to foot with a comic air
of bewilderment. "Then, Louise, what is it that you do to your dresses?"

"Wear them," she answered demurely. "And I shall surely wear this this
morning; it fits precisely."
Did it? Her husband was in great doubt. He would not have liked to own it; he
did not own it even to himself; but the truth was, he lived in a sort of terror of
his mother's opinions. She was easily shocked, easily disgusted; the whole
subject of dress shocked her, perhaps, more than any other. She was almost
eloquent over the extravagance, the lavish display, the waste of time as well
as money exhibited in these degenerate days in the decorations of the body.
She even sternly hinted that occasionally Dorothy "prinked" altogether too
much for a girl with brains. What would she think of Mrs. Lewis Morgan? The
dress which troubled him was one of those soft neutral-tinted cottons so
common in these days, so entirely unfashionable in the fashionable world that
Louise had already horrified her mother, and vexed Estelle, by persisting in
her determination to have several of them. Once purchased, she had
exercised her taste in the making, and her selections of patterns and trimming
"fitted the material perfectly," so Estelle had told her, meaning anything but a
compliment thereby.

It was simplicity itself in its finishings; yet the pattern was graceful in its folds
and draperies, and fitted her form to perfection. The suit was finished at the
throat with a rolling collar, inside of which Louise had basted a very narrow frill
of soft yellowish lace. The close-fitting sleeves were finished in the same way.
A very tiny scarlet knot of narrow ribbon at the throat completed the costume,
and the whole effect was such that her husband, surveying her, believed he
had never seen her better dressed, and was sure his mother would be
shocked. The bewilderment on his face seemed to strike his wife as ludicrous.

"Why, Lewis," she said gaily, "what would you have me wear?"

"I don't know, I am sure," he answered, joining her laugh. "Only, why should
fivepence goods look like a tea-party dress on you?" Then they went down to
breakfast.

Almost the first thought that the young wife had, as she surveyed the strange
scene, was embodied in a wonderment as to what Estelle would say could
she look in on them now.

That great, clean kitchen; the kettle steaming on the cook-stove, and the black
"spider" still sizzling about the ham gravy that was left in it; the large-leaved
table, spread; old-fashioned, blue earthenware dishes arranged on it, without
regard to grace, certainly, whatever might be said of convenience. In the
middle of the table sat the inevitable tallow candle, and another one blinked
on the high mantlepiece, bringing out the shadows in a strange, weird way.
Seated at the foot of the table was John, in his shirt-sleeves, the mild winter
morning having proved too trying for his coat. His father was still engaged in
putting the finishing touches to his toilet by brushing his few spears of gray
hair before the little glass in the further end of the room. Dorothy leaned
against the window and waited, looking both distressed and cross.

"Come! Come! Come!" said the mother of this home, directly the stair-door
had closed after the arrival of her new daughter. "Do let us get down to
breakfast; it will be noon before we get the dishes out-of-the-way. Now, father,
have we got to wait for you? I thought you were ready an hour ago. Come,
Lewis; you must be hungry by this time."

The rich blood mounted to Lewis's cheeks. This was a trying greeting for his
wife; he felt exactly as though he wanted to say that he thought so; but she
brushed past him at that moment, laying a cool little hand for an instant on his.
Was it a warning touch? Then she went over to the young man in the shirt-
sleeves.

"Nobody introduces us," she said, in a tone of quiet brightness. "I suppose
they think that brother and sister do not need introduction. I am Louise, and I
am sure you must be John; let's shake hands on it." And the small, white hand
was outstretched and waiting. What was to be done?

John, who was prepared to hate her, so well prepared that he already half did
so—John (who never shook hands with anybody, least of all a woman; never
came in contact with one if he could possibly help it) felt the flush in his face
deepen until he knew he was the colour of a peony, but nevertheless slowly
held forth his hard red hand, and touched the small white one, which instantly
seized it in a cordial grasp. Then they sat down to breakfast.

Louise waited with bowed head, and was thrilled with a startled sense of
unlikeness to home as she waited in vain. No voice expressed its thankfulness
for many mercies; instead, the clatter of dishes immediately commenced. "Not
one in the family save myself is a Christian." She remembered well that Lewis
had told her so; but was he of so little moment in his father's house that the
simple word of blessing would not have been received among them from his
lips? It had not occurred to her that, because her husband was the only
Christian in the household, therefore he sat at a prayer-less table.

Other experiences connected with that first meal in her new home were, to
say the least, novel. Curiously enough, her imaginings concerning them all
connected themselves with Estelle. What would Estelle think of a young lady
who came collarless to the breakfast table; nay, more than that, who sat down
to eat, in her father's and mother's presence, with uncombed hair, gathered
into a frowzly knot in the back of her neck? What would Estelle have thought
of Mrs. Morgan's fashion of dipping her own spoon into the bowl of sugar and
then back again into her coffee? How would she have liked to help herself with
her own knife to butter, having seen the others of the family do the same with
theirs? How would she manage in the absence of napkins and would the steel
forks spoil her breakfast? And how would she like fried ham, and potatoes
boiled in the skin, for breakfast anyway?

The new-comer remembered that she had but three weeks ago assured
Estelle that farmhouses were delightful places in which to spend summers.
Was she so sure of that, even with this little inch of experience? To learn to
appreciate the force of contrasts, one would only need a picture of the two
breakfast tables which presented themselves to the mind of this young wife.

Aside from all these minor contrasts, there were others which troubled her
more. She had resolved to be very social and informal with each member of
this family; but the formidable question arose, what was she to be social
about? Conversation there was none, unless Farmer Morgan's directions to
John concerning details of farm work, and his answers to Lewis's questions as
to what had transpired on the farm during his absence, could be called
conversation.

Mrs. Morgan, it is true, contributed by assuring Dorothy that if she did not
clean out the back kitchen this day she would do it herself, and that the
shelves in the cellar needed washing off this very morning. Whatever it was
that had occurred to put Dorothy in ill-humour, or whether it was ill-humour or
only habitual sullenness, Louise did not know; certainly her brows were black.
Would it be possible to converse with her? As the question put itself to her
mind, it called up the merry by-play of talk with which Estelle was wont to
enliven the home breakfast table, so sparkling and attractive in its flow that her
father had accused her of setting a special snare for him, that he might miss
his car.

If Estelle were at this table what would she talk about? It was entirely a new
and strange experience to Louise to be at a loss what to talk about. Books!
What had Dorothy read? She did not look as though she had read anything, or
wanted to. Sewing! Well, the new sister was skilled with her needle. Suppose
she said, "I know how to make my own dresses, and I can cut and fit my
common ones; can you?" How abrupt it would sound, and what strange table
talk for the pleasure of the assembled family! She caught herself on the verge
of a laugh over the absurdity of the thing, and was as far as ever from a topic
for conversation.
Meantime Lewis had finished his questionings and turned to her. "Louise, did
you ever see any one milk? I suppose not. If it were not so cold you would like
to go out and see Dorothy with her pet cow; she is a creature—quite a study."

Did he mean Dorothy, or the pet cow? It was clear to his wife that he was
himself embarrassed by something incongruous in the breakfast scene; but
she caught at his suggestion of a subject even while his mother's metallic
voice was saying—

"Cold! If you call this a cold morning, Lewis, you must have been getting very
tender since you were in the city. It is almost as mild as spring."

"Can you milk?" Louise was saying, meantime, eagerly to Dorothy. The
eagerness was not assumed; she was jubilant, not so much over the idea of
seeing the process of milking as over the fact that she had finally discovered a
direct question to address to Dorothy, which must be answered in some form.

But, behold! Dorothy, flushing to her temples, looked down at her plate and
answered, "Yes, ma'am," and directly choked herself with a swallow of coffee,
and the avenue for conversation suddenly closed.

What was she to do? How it was to call such distorted attempts at talk by the
pleasant word conversation! What "familiar interchange of sentiment" could
she hope to get up with Dorothy about milking cows? What did people say
about cows, anyway? She wished she had some knowledge, even the
slightest, of the domestic habits of these animals; but she was honestly afraid
to venture in any direction, lest she should display an ignorance that would
either be considered affected or sink her lower in the family estimation.
Suppose she tried some other subject with Dorothy, would she be likely to
choke again?

Mrs. Morgan tried to help. "Dorothy milked two cows when she was not yet
twelve years old!"

Whether it was the words, or the tone, or the intention, Louise could not tell;
but she immediately had a feeling that not to milk two cows before one was
twelve years old argued a serious and irreparable blunder in one's bringing
up. She was meek and quiet-toned in her reply:—

"I never had the opportunity of even seeing the country when I was a little girl,
only as we went to the sea-side, and that is not exactly like the country, you
know. All mamma's and papa's relatives happened to live in town."
"It must be a great trial to a woman to have to bring up her children in a city.
Ten chances to one if they don't get spoiled."

Mrs. Morgan did not say it crossly, nor with any intention of personality, but
again Louise felt it to be almost a certainty that she was thought not to belong
to that fortunate "one chance" which was not spoiled.

Mother Morgan startled her out of her wandering by addressing her directly—

"I hope you will be able to make out a breakfast. I suppose our style of living is
not what you have been used to."

What could Louise say? It certainly was not, and she certainly could not affirm
that she liked it better.

Her husband turned a certain troubled look on her. "Can't you eat a little?" he
asked in an undertone.

Did she imagine it, or was he more anxious that his mother should not be
annoyed than he was that her appetite should not suffer? Altogether, the
young bride was heartily glad when that uncomfortable meal was concluded
and she was back in that upper room. She went alone, her husband having
excused himself from his father long enough to go with her to the foot of the
stairs and explain that father wanted him a moment.

Do you think she fell into a passion of weeping directly the door of her own
room shut her in, and wished that she had never left the elegancies of her city
home or the sheltering love of her mother? Then you have mistaken her
character. She walked to the window a moment and looked out on the stubby,
partly frozen meadows that stretched away in the distance, she even brushed
a tender tear, born of love for the old home and the dear faces there; but it
was chased away by a smile as she bowed to her husband, who looked back
to get a glimpse of her; and she knew then, as she had known before, that it
was not hard to "forsake all others and cleave to him." Moreover, she
remembered that marriage vows had brought her more than a wife's
responsibilities. She was by them made a daughter and a sister to those
whom she had not known before. They were not idle words to her, these two
relationships. She remembered them each one: Father Morgan, with his old,
worn face, and his heart among the fields and barns; Mother Morgan, with her
cold eyes, and cold hand, and cold voice; Dorothy and John, and the fair,
yellow-haired Nellie, whom a special touch of motherliness had left still
sleeping that morning; and remembering them each, this young wife turned
from the window, and, kneeling, presented them each by name and desire to
her "elder Brother."

CHAPTER V.
BEDS AND BUTTON-HOLES.

How to fit in with the family life lived at the Morgan farmhouse was one of the
puzzles of the new-comer. For the first time, Louise was in doubt how to pass
her time, what to do with herself. Not that she had not enough to do. She was
a young woman having infinite resources; she could have locked the door on
the world downstairs, and, during her husband's absence in field or barn, have
lived a happy life in her own world of reading, writing, sewing, planning. But
the question was, would that be fulfilling the duties which the marriage
covenant laid upon her? How, in that way, could she contribute to the general
good of the family into which she had been incorporated, and which she had
pledged herself before God to help to sustain? But, on the other hand, how
should she set about contributing to the general good? Every avenue seemed
closed.

After spending one day in comparative solitude, save the visits that her
husband managed to pay, from time to time, to the front room upstairs, she,
revolving the problem, lingered in the large kitchen the next morning, and, with
pleasant face and kindly voice, said to Dorothy, "Let me help!" and essayed to
assist in the work of clearing the family table—with what dire results!

Dorothy, thus addressed, seemed as affrighted as though an angel from

heaven had suddenly descended before her and offered to wash the dishes;
and she let slip, in her amazement, one end of the large platter, containing the
remains of the ham, and a plentiful supply of ham gravy—which perverse stuff
trickled and dripped, in zigzag lines, over the clean, coarse linen which
covered the table. Dorothy's exclamation of dismay brought her mother
quickly from the bedroom; and, then and there, she gave a short, sharp
lecture on carelessness.
"What need had you to jump because you were spoken to?" she said, in
severe sarcasm, to the blazing-cheeked Dorothy. "I saw you. One would think
you had never seen anybody before, nor had a remark made to you. I would
try to act a little more as though I had common sense if I were you. This
makes the second clean table-cloth in a week! Now, go right away and wash
the grease out, and scald yourself with boiling water to finish up the morning."

Then, to Louise: "She doesn't need your help; a girl who couldn't clear off a
breakfast table alone, and wash up the dishes, would be a very shiftless sort
of creature, in my opinion. Dorothy has done it alone ever since she was
twelve years old. She isn't shiftless, if she does act like a dunce before
strangers. I'm sure I don't know what has happened to her, to jump and blush
in that way when she is spoken to; she never used to do it."

It was discouraging, but Louise, bent on "belonging" to this household, tried

again.

"Well, mother, what can I do to help? Since I am one of the family I want to
take my share of the duties. What shall be my work after breakfast? Come,
now, give me a place in the home army, and let me look after my corner. If you
don't, I shall go out to the barn and help father and Lewis!"

But Mrs. Morgan's strong, stern face did not relax; no smile softened the
wrinkles or brightened the eyes.

"We have always got along without any help," she said—and her voice
reminded Louise of the icicles hanging at that moment from the sloping roof
above her window. "Dorothy and I managed to do pretty near all the work,
even in summer time, and it would be queer if we couldn't now, when there is
next to nothing to do. Your hands don't look as though you were used to
work."

"Well, that depends," said Louise, looking down on the hands that were
offending at this moment by their shapely whiteness and delicacy; "there are
different kinds of work, you know. I have managed to live a pretty busy life. I
don't doubt your and Dorothy's ability to do it all, but that isn't the point; I want
to help; then we shall all get through the sooner, and have a chance for other
kinds of work." She had nearly said "for enjoyment," but a glance at the face
looking down on her changed the words.

Then they waited; the younger woman looking up at her mother-in-law with
confident, resolute eyes, full of brightness, but also full of meaning; and the
older face taking on a shade of perplexity, as if this were a phase of life which
she had not expected, and was hardly prepared to meet.

"There's nothing in life, that I know of, that you could do," she said at last, in a
slow, perplexed tone. "There's always enough things to be done; but Dorothy
knows how, and I know how, and—"

"And I don't," interrupted Louise lightly. "Well, then, isn't it your bounden duty
to teach me? You had to teach Dorothy, and I daresay she made many a
blunder before she learned. I'll promise to be as apt as I can. Where shall we
commence? Can't I go and dry those dishes for Dorothy?"

Mrs. Morgan shook her head promptly.

"She would break every one of 'em before you were through," she said grimly;
"such a notion as she has taken of jumping, and choking, and spilling things! I
don't know what she'll do next."

"Well, then, I'll tell you what I can do. Let me take care of John's room. Isn't
that it just at the back of ours? I saw him coming from that door this morning.
While you are at work down here, I can attend to that. May I?"

"Why, there's nothing to do to it," was Mrs. Morgan's prompt answer, "except
to spread up the bed, and that takes Dorothy about three minutes. Besides, it
is cold in there; you folks who are used to coddling over a fire would freeze to
death. I never brought up my children to humour themselves in that way."

Louise, not wishing to enter into an argument concerning the advantages and
disadvantages of warm dressing-rooms, resolved upon cutting this interview
short.

"Very well, I shall spread up the bed then, if there is nothing else that I can do.
Dorothy, remember that is my work after this. Don't you dare to take it away
from me."

Lightly spoken, indeed, and yet with an undertone of decision in it that made
Mrs. Morgan, senior, exclaim wrathfully, as the door closed after her daughter-
in-law,—

"I do wish she would mind her own business! I don't want her poking around
the house, peeking into places, under the name of 'helping!' As if we needed
her help! We have got along without her for thirty years, and I guess we can
do it now."
But Dorothy was still smarting under the sharpness of the rebuke administered
to her in the presence of this elegant stranger, and did not in any way indicate
that she heard her mother's comments, unless an extra bang of the large plate
she was drying expressed her disapproval.

As for Louise, who will blame her that she drew a little troubled sigh as she
ascended the steep staircase? And who will fail to see the connection
between her thoughts and the action which followed? She went directly to an
ebony box resting on her old-fashioned bureau, and drew from it a small
velvet case, which, when opened, revealed the face of a middle-aged woman,
with soft, silky hair, combed smooth, and wound in a knot underneath the
becoming little breakfast cap, with soft lace lying in rich folds about a shapely
throat, with soft eyes that looked out lovingly upon the gazer, with lips so
tender and suggestive, that even from the picture they seemed ready to speak
comforting words.

"Dear mother!" said Louise, and she pressed the tender lips again and again
to hers. "'As one whom his mother comforteth.' Oh, I wonder if John could
understand anything of the tenderness in that verse?" Then she held back the
pictured face and gazed at it, and something in the earnest eyes and quiet
expression recalled to her words of help and strength, and suggestions of
opportunity; so that she closed the case, humming gently the old, strong-
souled hymn, "A charge to keep I have," and went in search of broom, and
duster, and sweeping-cap, and then penetrated to the depths of John's room;
the development of Christian character in this young wife actually leading her
to see a connection between that low-roofed back corner known as "John's
room," and the call to duty which she had just sung—

"A charge to keep I have,

A God to glorify."

What, through the medium of John's room! Yes, indeed. That seemed entirely
possible to her. More than that, a glad smile and a look of eager desire shone
in her face as she added the lines—

"A never-dying soul to save

And fit it for the sky."