Jack returns to work, and Willie is insensitively outraged that the Judge has killed himself to escape the Boss's blackmail. Jack refuses to continue blackmailing people for Willie, but he remains a part of Willie's operation.
Willie decides to stop MacMurfee by buying off his main backer, contractor Gummy Larson--by giving him the contract for Willie's medical center. In a meeting between Willie and Gummy, Willie castigates Tiny Duffy, who had recommended and desired giving Larson the contract as a way of neutralizing MacMurfee from the start, and who stands to make a substantial kickback from the affair. He also blasts Larson, who is in the process of selling out his friend. The two take the Boss's drunken raving in silence. The Boss accidentally splashes Duffy's face with alcohol and breaks a glass on the floor. The Boss tells Larson the deal is arranged, and Larson and Duffy depart. Jack and Willie talk briefly before Willie passes out. Willie says he wants the hospital built perfectly, and he does not blame his son for the situation he was in. Jack leaves Willie in the care of Sugar-Boy.
One Saturday night, Tom and two other members of the team get into a fight at a roadhouse, and the coach, pressed by the publicity the event receives, suspends Tom. The team loses the next game, and Willie pressures the coach into letting Tom play again. Two games later, Tom is tackled and does not immediately get up. The Boss is unconcerned, thinking his son will be back on his feet presently, so he focuses on the game instead. Near the end of the game, Willie is called to the field house to see his son, and he tells Jack to go back to the office and wait for him there. Jack goes back, finds the place completely empty, then sets to work on tax figures in his office. He hears Sadie Burke crying. She is displeased to see Jack, and she says she plans on leaving town for good. Jack tells her what happened to Tom, and she cuts the conversation off and leaves. Jack returns to his office, where he receives a call from Sadie, who has gone to the hospital. She tells him that that Tom is still unconscious and that Willie wants to see him.
At the hospital, Willie informs Jack that a specialist is being flown in, and he tells Jack to get Lucy. Once she arrives, Lucy and Willie nervously bicker in the waiting room, and he maintains that Tom will be all right. Adam, who is treating Tom, tells Jack that Tom is unconscious and paralyzed--he has just a chance of being all right. Downstairs, Jack runs into Sadie, who has been waiting there as Willie and Lucy have been waiting upstairs, and who desperately forces Jack to tell her what happened. Finally, Jack receives a call from Anne, who is equally desperate for an update on Tom's situation.
After a specialist sees Tom, Adam tells Willie and Lucy that they have a serious choice. Adam could either put Tom in traction and wait it out, or they could perform surgery to find out whether the spinal cord is crushed (in which case Tom would be paralyzed forever) or just being pressed upon, in which case the pressure could be relieved. Adam warns that the surgical option is the more radical of the two and that it could be fatal. Willie tells him to perform the surgery, and Lucy quietly agrees. While they wait, Willie says he will name his hospital for Tom, but Lucy says things like that do not matter.
After the surgery, Adam says that Tom will live, yet his spinal cord has been crushed, and he will remain paralyzed. Lucy and Willie leave the hospital, and Jack tells Anne and Sadie what happened.
Monday morning, Willie's office is flooded by telegrams with condolences. Jack finds there a large group of cabinet members, including Tiny Duffy, who give their sympathy to the Boss personally. Willie walks in and receives their wishes coldly, then dismisses the telegrams. Then he informs Tiny Duffy that he has decided to break the deal with Gummy Larson. Duffy pleads with Willie not to break his word, but Willie is obstinate. Jack tells Willie that Larson would not take as much abuse as Tiny Duffy, and Willie responds, "You got to start somewhere" (532). Later that day, Willie and Sadie have a loud argument that causes Sadie to leave the office in a rush.
That afternoon, Jack receives a message from Anne about an urgent matter. He goes to her apartment, and she is hysterical. He shakes her, and she tells him that Adam visited her earlier and told her that someone had called him and told him about her relationship with Willie. The caller said that the only reason Adam was named director of the hospital was because of Anne, and that because of what Adam had done to Tom, Willie was going dismiss him as director and leave Anne. Then Adam said he would not "be pimp to his sister's whore" and left abruptly. (538) Anne begs Jack to find Adam, and he goes out to search the city.
That evening, Jack leaves messages for Adam all over town. He then waits in the hotel lobby, where he reads the paper and ruminates over the Boss's willingness to use corrupt practices in order to help the poor of his state.
At 9:00 pm, Jack receives Willie's request to meet him at the Capitol, and Jack goes there to find out that his tax bill has passed. He goes to the Senate, where he finds Willie talking to some legislators. Willie and Jack walk through the Capitol lobby, where Jack sees a very haggard Adam. Adam approaches the two, and Willie extends his hand. They shake hands, and then Adam pulls out a pistol and shoots Willie twice. Sugar-Boy and a highway patrolman fire on Adam, striking him dead.
Willie is rushed to a hospital and operated on. Lucy and her sister wait alongside Jack. The operating doctor tells Jack that Willie might live and shows him the pieces of lead removed from Willie's body. Jack reflects that Adam had shot his boss with the same gun the two used to shoot with when they were kids.
A few days after the operation, Willie takes a turn for the worse. One evening, he summons Jack to his bedside. He tells Jack that Adam "was all right," then pleads that if he had not been shot, "It might have been all different" (550). Willie dies the next morning. He later has a massive state funeral in the Capitol. Jack concludes the chapter by introducing Adam's funeral in Burden's Landing, which he had attended before attending Willie's.
At last, the untenable universe of All the King's Men comes crashing down around Jack Burden. Upon his return to the capital, he refuses to do any more blackmailing for Willie, although he continues to work in Willie's administration. The story of Jack's redemption now takes a backseat to the story of Willie's.
Willie commits perhaps the worst selling out of his political career by awarding the hospital contract to Gummy Larson. The hospital represents all that is good about Willie's intentions. He went to great lengths to get it overseen by the ethical and upright Adam Stanton. By allowing it to "touch filth" through Larson's corrupt deal, however, he has abandoned the last of his principles and his good intent. He is insolent and ashamed, lashing out at the stone-faced Gummy and the victorious Tiny Duffy. He has dug himself into a hole through his dirty game of politics, and his hands are tied in the matter.
The first Stark blood is spilt by the proud Tom, who is punished for his freewheeling pride by the loss of his body. Just as Tom's life is destroyed on the football field in a game he played while abandoning morality in his social life, his father's life ends in the state capitol in the midst of the political game he played while abandoning all scruples.
In the middle of the chapter, Willie tries to repent and undo the damage he has caused by leaving Anne and returning to his wife, and by taking the immediate step of revoking the contract. He is, however, too far in at this point. This revocation causes Tiny Duffy to place the phone call that ultimately ends the Boss's life. Essentially, Willie's decision to reject corruption and change his ways causes his own death in a way that mirrors Judge Irwin's own brave stand in the preceding chapter. Both stands are held in the name of high ideals, and both result in what is essentially self-inflicted death. In this sense Jack is right about people choosing their own demise.
Adam's assassination of Willie is driven by complex motivations. Adam had always had a great deal of animosity towards Willie and his lack of ethics. Essentially, Adam "snapped" after learning that Anne was Willie's mistress. He could no longer tolerate the governor's tyranny. Beneath this level, Adam is also motivated by his chivalrous ideals of the "Old South." Much like Duncan Trice from the story of Cass Mastern, Adam believes in family honor, and in the context of the affair, he considers killing Willie to be his duty. In addition, Adam's brazen assault is functionally suicidal. He has likely accepted guilt for having worked with Willie and for the shame that having done so has brought to his family. At least, he can predict that killing Willie is an action also to kill himself.
On his deathbed, Willie insists that he never did anything to Adam, implying once more the divide between the ideals of Willie and those of Adam. In the midst of his late transformation, Willie was taken down because of Adam's family pride. Essentially, Willie has been the victim of a complex combination of his own machinations and the values of the Old South that seem to violently reject the concept of simple redemption. Judge Irwin's and Duncan Trice's only recourse is suicide; Cass Mastern must spend his life in penance for his misdeed; Willie Stark and Adam Stanton apparently must die.