MacDonald is the work’s author and narrator. When the book begins, an adult MacDonald is visiting “Southie,” the South Boston neighborhood where he was raised. The Southie of his childhood in the 1970s was an intense place of violence, drugs, police corruption, and racism. During his childhood, he lost several brothers to either street violence or suicide, and the emotional fallout of those losses is one way the memoir reveals The Widespread Impact of Abandonment. His memories are largely an endless string of fistfights, stabbings, riots, and attending wakes for friends and family. After the murder conviction of his 13-year-old brother, Stevie—who was innocent—Michael committed to a life of anti-violence and anti-corruption activism. As the book ends, he has found that his new work has given him a sense of purpose and may allow him to make peace with the suffering he knew as a boy.

Known as Ma throughout the book, Michael’s mother is bawdy and unconventional, wears mini-skirts and high heels everywhere she goes, fistfights while pregnant, plays the accordion in local pubs, and threatens anyone who menaces her family with knives, scissors, and firearms. However, Ma is unable to protect her children from the dangerous streets of Southie.