Chapter 18: Neeley and Francie have been making mud pies, and they arrive at a clinic to be vaccinated against smallpox looking very dirty. The doctor, who has been forced to do community medicine in a free clinic, sees the dirt on Francie and begins disparaging the poor, whom he calls filthy and not even capable of using soap and water. Francie is deeply ashamed and hurt by the comments. When her vaccination is finished, she tells the doctor that he does not need to repeat his comments for her little brother.
After the vaccination, Francie's arm becomes infected. Katie has told the children that if they scratch the injection site that the wound will become infected and their arms might turn black and fall off. Francie lies awake at night, afraid that she is going to die. When Johnny comes home, he cleans the wound and re-bandages it, soothing Francie, whose arm is much better in the morning.
Chapter 19: Although Francie had been looking forward to school, she realizes right away that she will never be the teacher's pet. The teacher likes only the rich children, who arrive in fancy clothing. The poor children, with their threadbare clothing, are forced to sit in the back of the classroom. The bullies rule the recesses and do not allow the poor children to use the bathrooms. Likewise, the teachers will not allow the poor children to use the bathrooms except at recess. Half of the children learn to hold their urine, while the other half wet their pants. One day, Sissy arrives as school is letting out and takes Francie for a soda. Francie is deeply ashamed that she has wet her pants and knows that her mother will scold her. The next morning, Sissy goes to Francie's teacher. Sissy threatens and intimidates the teacher, who does not believe all that Sissy says, but in the future she allows Francie to use the bathroom.
