Nicholas Kristof's friend Rick was born into a lower class family. At the age of five years old, his mother died and his father was a drunk, not very involved in his life. He lived with his grandmother along with three siblings, so sharing, compromising, and sacrificing was a part of his life from the start. He went through school with undiagnosed ADD. While he was a very smart guy, he didn't have the accommodations and help that he needed so he dropped out of high school, immediately giving him limited job opportunities. He went through marriages and divorces, having children to support and new expenses. After an accident at work that "mashed" his hand, he "survived on disability and odd jobs." He worked his entire life to take care of others and not himself. He had been taught that he was not the most important person from an early age. He was destined to fail from the Domino Effect due to the fact that he was of low income, had miniscule connections, and didn't get the proper medical care that he needed.
Kristof mentioned that "what distinguished Rick wasn't primarily bad choices, but intelligence, hard work, and lack of opportunity." By not getting help for his ADD, he was immediately discouraged and didn't have anyone to help him, such as an aid, or a psychologist, because he didn't have the money to pay for those things. He was very smart, he just couldn't learn in a classroom setting. He worked hard his whole life to support children and wives, even giving up money for his ex-wife who needed medical help. He had learned to give up things for the people he loved and to work hard to support not only himself, but more importantly, his loved ones. And since he didn't have a college education where he was prepared for a certain field, he was thrown into the job market as a teenager and forced to make do with what he could find.
He was destined to be lower income since the moment he was born. Society just kept keeping him down, unable to rise above.