“We were all nearby one another, close enough to lend a hand, yet far enough apart to blanket ourselves in the illusion of isolation.”

Lulu has relatively close relationships with a few of her neighbors, like Nora. Lulu is also aware, however, that geographical proximity allows the women in her circle to spy on each other, assessing which of them aptly fulfill their roles as wives and mothers. The emotional isolation that Lulu often feels is intense, but the lack of privacy means that conformity norms dominate the community.

“Not a single hair looked out of place. Except for Bitsy. She looked different—taut skin and no gray hair. While she was surrounded by three happy family members who all looked in the same direction, Bitsy looked off to the left.”

When Lulu looks at a family portrait of the Betsers, she notices that Gary and their two boys face one direction while Bitsy looks in another. This posture is symbolic of her difference, suggesting that she is the only person in her family to question or deviate from social norms. This is, perhaps, unsurprising since she’s the only woman in the picture.

“The woman barely spoke, didn’t make eye contact, shared little else other than that forced smile that seemed designed to act as a fortress. The question was: What was it guarding?”

Lulu is put off by Bitsy’s aloof demeanor. Using a simile, Lulu compares Bitsy’s smile to a “fortress” meant to protect someone from outsiders. This comparison shows how perceptive and insightful Lulu is. It also shows how desperate Bitsy is to seem “normal” after her lobotomy has hollowed out her inner life.

“Don’t get ahead of yourself. I heard Henry’s voice in my head. He always told me that when he thought I was worrying too much, as if those words would stop the racing thoughts.”

Henry’s instruction to Lulu is evidence of his neglectful and unobservant treatment of his wife. His advice to slow down is well meant, but he does not notice how this generic and not-particularly-helpful warning comes across to Lulu, whose “racing thoughts” are hard to control and whose “worrying too much” only increases after her daughter’s death.

“One of the best decisions we ever made was getting our kids on the same nap schedule so that we could get in a couple hands of spades during rest time.”

Despite the many obstacles preventing the women of Greenwood from becoming true emotional support for one another, they still manage to find some creative solutions to their oppressive lives. Here, Lulu is proud that they’ve figured out aligning their children’s naps so that they can have time to play cards for an hour. The women are expected to be entirely selfless, but if their children are sleeping, they don’t have to feel guilty for finding time for themselves.

“I began to wonder if we all knew her. Maybe she had a cleaning schedule taped to her fridge. Maybe she also got tired of ironing underwear. Maybe she woke in the night and sat in the shadows, wondering if dawn would break like it did each morning. Or if, just one time, the moon would blanket the sun and the night creatures would bask in the continuing darkness. Or maybe that was just me.”

The “despondent wife” who died by suicide while her daughter played in another room becomes a symbol of the isolation and restriction that the novel’s wives feel. Lulu doesn’t know the woman who died, but her imaginative attempt to cast herself into the woman’s life suggests that being a woman who pretends that everything is fine but who is secretly miserable is not a foreign idea. The passage uses anaphora, with the repetition of the word “maybe” at the beginning of sentence fragments, to underscore the stultifying repetitiveness of the lives imposed on women like Lulu.

“The men, even the doctors. They may see certain sides of pregnancy and birth, but they don’t experience it in a way that they know what it’s really like.”

Lulu laments that male doctors cannot understand how difficult pregnancy and the postnatal months can be; her expectation that only men are doctors lines up with the fact that by 1960, fewer than 6% of American doctors were women. The dearth of women in the field made The Dangers of Medical Misogyny far more prevalent.

“Was anyone well and truly happy? Yes, they were. They had to be. It was me; I was the problem.”

Lulu’s internalized misogyny engenders a fear of expressing any dissatisfaction with her role as a wife and mother. She assumes that the performance of happiness she sees around her reflects real feelings, leading her to believe that she is alone: “I was the problem.” The terribly isolating shame of women like her maintains this system.

“‘We call this hysteria.’ He said it so matter-of-factly. I didn’t feel hysterical, and I wanted to tell him that, but I feared that anything I said would only prove his point. Instead, I smiled and nodded.”

When Lulu tells Dr. Collins her symptoms, he diagnoses her with “hysteria,” a gendered and demeaning term for specifically women’s emotional distress. Scientifically unproven, this diagnosis instead comes from the belief that women are more fragile than men, enabling the kind of misdiagnosis that exposes Lulu to the dangers of medical misogyny.

“Instead, I felt like I was suspended in one of my own gelatin salads, wobbling, yet held on display as life continued beyond my reach.”

Lulu uses a simile to compare herself to one of her Jell-O creations. She feels “suspended” and “wobbling,” as though she’s being propped up and animated by family and social expectations rather than her own will. Like the attention-catching dish, she feels “on display”; also like the dish that uses engineering and chemistry to make vegetables into an alien creation, Lulu feels separate from “life” that she cannot reach.

“I mean, if it was up to me, I’d just as soon let the cat go, but she’s gone and gotten attached.”

Gary asks about Bitsy’s cat in a disrespectful and degrading way that highlights Patriarchy’s Infantilization of Women. His tone clearly conveys his condescension: He believes that Bitsy is being ridiculous and immature for getting “attached” to a pet. He thinks of Bitsy’s feelings as inferior and sentimental; unlike him, she can’t “let the cat go.”

“I had to pretend as if I had everything under control, that as Henry’s wife, my days were spent anticipating his needs and I was happy to oblige, because if I didn’t, someone like her was waiting and willing.”

Lulu’s concern that Henry is being unfaithful to her grows when he gets a new secretary. Lulu is aware that many women would happily fill her role; she fears alienating her husband because if he leaves her, she will have little ability to support herself financially. The obligation to “anticipate his needs” in exchange for his continued good will makes their marriage seem transactional rather than based on reciprocal feelings.

“Now, with empty arms, I needed so much more. But [Nora] wasn’t there when I needed her. No one was. What did I expect? When had anyone been there when I needed them most?”

When Lulu finally realizes that Esther died in childbirth, she feels abandoned. Neither her husband nor her friends are “there when [she] need[s] them”—no one offers condolences for the loss that the Mayfields experienced, and there is no funeral or ceremony for the dead child. Instead, Lulu’s circle assumes that silence and obfuscation are the way to restore emotional equilibrium—an extremely harmful and dysfunctional coping strategy.

“He pressed around me like a straitjacket, suppressing any movement of my arms.”

When Henry catches up with Lulu, who has just processed that Esther died, he tries to get her to be quiet because other people are watching. Her simile compares the way he physically restrains her to straitjacket, a garment used to imprison people with mental illness, foreshadowing her treatment in the sanatorium. There, doctors will assume that she only has a mental illness, miss her symptoms of lupus, and restrict her freedom and agency through a variety of tranquilizing treatments.

“‘Rest and get better.’ He said it as if it was as simple as that, as if a little nap would fix it all. As if this was a passing fever and tomorrow I’d be right as rain. My empty arms and aching bones knew I needed help, but what I also needed was a husband who believed me.”

When Henry leaves her at the sanatorium, Lulu is shocked at his tone and choice of words. Underscoring patriarchy’s infantilization of women, he treats her like a child, acting as though this involuntary confinement is nothing more than a “little nap” that will make her function perfectly again. Although Henry loves Lulu, he has been socialized into disregarding her autonomy and not “believing” her.

“‘Don’t tell the doctor,’ the nurse said with a wink as she handed the woman a lollipop. The woman scrambled to unwrap it and pop it into her mouth as quickly as possible.”

This quick scene offers a look at the complicated gender and authority dynamics of the sanatorium. The female nurse and patient are shown to be in collusion against the overarching power of male doctors; the lollipop is contraband that both will keep secret. However, the nurse is part of the medical community whose practices exhibit the dangers of medical misogyny: She feels for the patient but believes that the woman is much better post-lobotomy than she used to be, accepting the misinformation that this procedure is an effective way to manage mental illness. Finally, the idea that the one piece of comfort the nurse can deliver is a lollipop feeds into patriarchy’s infantilization of women: The patient has been surgically rendered childlike.

“While I was locked away in a room, they had talked about me as if I were a child.”

Dr. Ruthledge’s practice of talking about Lulu with Henry when Lulu isn’t there to speak for herself is deeply upsetting to her. The scene builds on the novel’s depiction of men discussing their wives disparagingly behind their backs. However, treating Lulu “as if [she] were a child” has even more significant ramifications when health is on the line; Ruthledge misdiagnoses Lulu because he specifically ignores her, exposing her to the dangers of medical misogyny.

“I continued playing the part as he explained that grief can do strange things to us, especially to mothers. To women.”

Even when Lulu is included in conversations about her health and potential treatments, Ruthledge is patronizing. In response, she must “play the part” of the acquiescent, obedient woman, as standing up for herself or correcting his understanding of her experience would only confirm his sexist biases. His belief that grief is worse for mothers, and for women in general, conveys his sense that women are weaker than men.

“And if I melted then, what would that mean for my prognosis? So I played at being the good girl, the one who followed instructions, the one who did what was expected of her.”

Lulu, an adult woman, adopts the pose of the “good girl” to attempt to outwit Ruthledge. His misogyny would read her crying over the loss of her daughter as worsening symptoms of mental illness. Just as she does at home with the Good Housekeeping cleaning schedule, Lulu must adopt external “instructions” in the new setting of the sanatorium to retain some measure of agency.

“I screamed to myself from the inside to wake up, sit up, and say what he needed to hear. I tried to be the patient he wanted me to be, to play the game he set for me. If I won, I went home.”

In a metaphor, Lulu compares her interactions with Ruthledge to a game with horrifying stakes. Despite her untreated autoimmune disorder, postpartum depression, and grief, she tries to compel herself “be the patient he want[s] [her] to be”—a compliant and calm woman. Tamping down all her responses and personality could allow her to “win” and “go home”; losing likely means being subjected to less humane treatment than she’s already endured.

“He paused because he wanted my undivided attention.”

Like a teacher or parent who pauses to make sure they have a child’s “undivided attention,” Ruthledge treats Lulu like an intellectually inferior audience, reflecting his deep biases and, more generally, patriarchy’s infantilization of women.

“Would this earn me a lollipop, too?”

Lulu compares her upcoming electroconvulsive therapy to the lobotomy performed on the female patient she observed earlier. Ruefully, she wonders if her acquiescence will result in the same childish prize of “a lollipop,” knowing that she is unlikely to experience any actual amelioration of symptoms.

“I picked him up and held him down. It was for his own good, I had told myself. It’s for her own good, they told themselves.”

As she is manhandled into the treatment room, Lulu recalls taking Wesley to the doctor for a vaccination. Frightened of needles and incapable of understanding the need for this preventive measure, Wesley became intensely agitated and fought back. Lulu told herself that the shot was “for his own good”—just what Henry says to convince her to agree to the treatment Ruthledge prescribes. Lulu compares herself in the past with the men surrounding her in the present, as in both cases, those in authority justify their actions by the same phrase.