In studying the drug culture of Kensington, the novel examines the problem through the experiences of Mickey and Kacey. To a casual observer, their lives start out in an identical fashion. Both are born to a drug-addicted mother who dies when Kacey is two years old. Both are raised by their resentful grandmother, Gee. However, the sisters make wildly divergent choices that result in tragedy for one and a stable future for the other.
The author seems to be revisiting the old nature-nurture argument in trying to decide what force is ultimately responsible for the way that the sisters’ lives turn out. At one point, Kacey is complaining that her lot in life is so much harder than Mickey’s. The latter is baffled by this remark:
I looked at her, blinking, and said to her as levelly as I could that I grew up in the same household as she did. My implication, of course, was that it is the decisions that I have made in life that have placed me on my specific path—decisions, not chance (77).
However, the explanation becomes more nuanced as more details of Kacey’s past emerge. Both Mickey and the reader later learn that Kacey was born addicted to heroin while Mickey was not.
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