Despite the pub being located in a relatively wealthy location, it's customers are often poor, addicted to drugs and considered to be the dregs of society. Isaac doesn't fit in with the impoverished people who frequent The Dying Child; his intelligence and role as a professor directly contrast the ignorant, unemployed customers and their favourite local tavern. In fact, drug-use is common within the pub itself; "a group of emaciated young men lay draped out on a table, twitching in perfect time, strung out on shazzbah or dreamshit or very-tea."
Numerous ex-criminals and current offenders visit the pub; it's known as a place where illegal information is discussed whilst also being a location to trade and use mind-altering substances such as dreamshit.
Isaac visits The Dying Child with the goal of obtaining dreamshit which is the drug he uses to experiment upon the worm within his laboratory. Apparently, Isaac usually visits "salubrious" inns with better quality food and drink but continues to return to The Dying Child for research purposes and sentimental reasons. Ironically, he appears to enjoy the cheap ale which is served to him; the barman actually knows his favourite drink, "Kingpin" and preemptively gives him a glass.
The Dying Child is utterly dishevelled; minimal light reaches into the murky depths of the pub where dirt adorns the walls. It's dilapidated appearance is akin to it's shabby customers, many of whom visit the pub to take drugs or drink massive amounts of alcohol. Almost no-one has ever sat outside the pub, its tables are apparently covered in fungus and the courtyard filled with weeds. Many of the customers seek the social interaction within the pub and are evidently unphased by its appallingly unhygienic appearance.