Inside The Larkspur are not only the aging but also mental patients, put there in the 1970s after the government closed down mental institutions in an effort to save costs. The patients are threatened and doped; mice abound (exterminators are expensive, flatly states the administrator, who has her own secrets); politicians are in cahoots with venture capitalists who set up this string of 32 nursing homes in 7 states; Human Services can't check out every complaint; political favors (this is Chicago, remember) are repaid through warning nursing homes of impending visits by Human Services; Chips, lying in soiled bedclothes, is kept sedated--these conditions set the stage for murder and for Jimmy's determination to improve them. From Jimmy's wife Mary, a nurse, we get an idea of the ways modern medicine often confuses the issue of how the elderly should be treated.

Jimmy, a decent man ("I don't think anybody's insignificant," he says simply and honestly to one politician [196]), reminds us why it's hard to improve such conditions: "It's easy to say things should be better but nobody does anything"(136); "We'd vote against taxes"(144); "Worst thing about getting old is that it turns us into cowards because we figure there ain't gonna be nobody around to take care of us if we don't do it ourselves."(200)