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old doctor had dismissed as nothing important. The new doctor requested an MRI, which led to the diagnosis of spina bifida. Her vertebrae were tethered to the bottom of the spinal cord, pulled tight as a rubber band. Without treatment, the stretching would aggravate over time. The barrage of tests and doctor’s visits took Lisa out of work periodically. Jenna’s doctorsrecommended surgery to correct the malady, and between that and aftercare, Lisa and Alan were looking at thousands of dollars in medical bills. At the same time, as the housing bubble popped, businesses throughout Florida failed, including the cell phone reseller. Alan lost his job.
    The cascade of financial and emotional pressures overwhelmed the young couple, their relationship suffering the collateral consequences of the mounting pile of debt. Compounding this was the fact that Lisa and Alan dared not tell family or friends about their money troubles. Anybody in Florida in 2007 could recognize a foreclosure crisis if they paid attention—a moving truck in the driveway, packed boxes on the curb with a crude sign attached reading “Free”—but you’d almost never hear about it in public. Neighbors who lost their homes drove down property values, which led to more foreclosures and more drops in home prices. So people had powerful reasons to keep to themselves, to try to solve their problems in isolation, lest they be identified as the source of the community’s downward spiral. As a result, the foreclosure wave swept through Florida practically in silence.
    In January 2008 Lisa made some calculations and determined she could pay the mortgages on the house and the condo for nine more months. After that she would need financial help for the first time in her life. She called her mortgage company, hoping it could modify the payment or work something out. Though Lisa had taken out the loan with DHI Mortgage, early on she was advised to mail payments to Chase Home Finance, a division of JPMorgan Chase, one of America’s biggest banks. The whole thing always seemed a little suspicious. But JPMorgan Chase’s stature encouraged Lisa about the prospects for assistance. The company boasted of its “fortress” balance sheet. When the investment bank Bear Stearns failed in March 2008,government officials solicited Chase to buy it. Lisa read about other banks failing left and right, but Chase seemed secure. Surely it had some smart people who could make this all work.
    She talked to a Chase Home Finance representative. “I have nine months to work something out,” she said. “We have plenty of time, I have a perfect credit score, and I’ve never paid anything late. What can we do?” The representative told her to fax in financial documents and they would get back to her. Lisa did what she was told but never heard anything. She called back the next week. And the next week. And the next.
    Lisa never talked to the same person and would constantly have to explain her story from scratch. They always requested new copies of the documents, claiming to have lost the previous ones. Lisa spent a fortune in copy and fax charges; it was as though the documents she sent drifted into a black hole. And there didn’t seem to be any consistency from one Chase representative to the next. Someone would tell Lisa she was days away from approval, and the next employee would have no record of her application, forcing her to start over. The ordeal took enough time and effort to become a second job.
    At the cancer center, Lisa increasingly found herself enmeshed in her patients’ financial crises, just as she struggled to deal with her own. It was customary for patients to ask for a doctor’s signature confirming their diagnosis so they could present it to creditors and secure financial relief. But patients would come back multiple times to Lisa, asking for another doctor’s note, and then another. The mortgage