What does the author suggest by Mrs. Hales's statement in chapter 8 that she did not know what Zeena would do if she did not have Ethan to look after her?

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In Chapter VIII of Ethan Frome, Edith Wharton writes,

Beaming maternally on Ethan, she bent over to add: "I on'y just heard from Mr. Hale 'bout Zeena's going over to Bettsbridge to see that new doctor. I'm real sorry she's feeling so bad again! I hope he thinks he can do something for her. I don't know anybody round here's had more sickness than Zeena. I always tell Mr. Hale I don't know what she'd 'a' done if she hadn't 'a' had you to look after her; and I used to say the same thing 'bout your mother. You've had an awful mean time, Ethan Frome."

These compassionate words of Mrs. Hale, ironically, work against Ethan as they cause him to repress his personal desires.  Because Mrs. Hale has been kind, but also suggests Zeena's place in their community, Frome rethinks his plans to trick Andrew Hale into giving him money.  For, his sense of ethics and duty and obligation toward his community deter Frome from his personal plans; in short, it becomes impossible for Ethan to rebel against his social order and geography.

This passage of Ms. Wharton's points to the tyranny of social custom that was part of the Puritanical New England with its inflexible more code and its starkness, symbolized by the town's name of Starkfield.

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