With a cane, she is able to make a long walk from her home to the hospital, and only needs someone to tie her shoe because she cannot, because she is using a cane.
The tale is set in winter, in the South, after the Civil War. The lack of respect shown towards the poor woman who has walked so far may have a great deal to do with her race as well as her poverty and lack of education. Phoenix says she "never did go to school, I was too old at the Surrender." Notice that Phoenix calls the end of the Civil War 'the surrender' as many proud Southerners might which suggests the Southern point-of-view the 'correct' side surrendered, rather than simply saying that the war ended. The doctor also says: "She makes these trips just as regular as clockwork," reflecting the Southern dialect of the setting and...
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