65 pages • 2-hour read
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Content Warning: This section of the guide contains discussion of mental illness, gender discrimination, and emotional abuse.
Gather initial thoughts and broad opinions about the book.
1. How did your perception of Elizabeth Packard evolve throughout the book? Like Kate Moore's earlier work The Radium Girls, this book examines one woman's fight against systemic injustice. How do these narratives compare in their approach to highlighting historical wrongs?
2. What was your initial reaction to learning how easily a husband could commit his wife to an asylum in the 1860s? How did this shape your understanding of women's historical vulnerability?
3. Which scenes or moments in the book did you find most powerful or memorable? What made them stand out?
Encourage readers to connect the book’s themes and characters with their personal experiences.
1. Elizabeth refused to compromise her beliefs even when faced with imprisonment and separation from her children. Have you ever had to stand up for your convictions at great personal cost? How did you handle it?
2. The book explores how Elizabeth maintained her dignity and sense of purpose despite degrading circumstances. How do you think you would respond if you were stripped of your basic rights and freedoms?
3. Elizabeth found ways to help others even while confined to the asylum's Eighth Ward. When have you witnessed or experienced the power of maintaining humanity in difficult circumstances?
4. How did Elizabeth's relationship with her children affect you emotionally? What aspects of their separation and eventual reunion resonated most strongly?
5. The author describes Elizabeth's “shadow stitched to her”—the lasting stigma of being labeled insane. How do you think mental health stigma has evolved since Elizabeth's time?
Examine the book’s relevance to societal issues, historical events, or cultural themes.
1. How does the book’s exploration of women’s rights in the 1860s illuminate current debates about gender equality and bodily autonomy?
2. The role of religion features prominently in Elizabeth’s story, both as a source of oppression and strength. How do you see religion’s dual nature playing out in contemporary social issues?
3. What parallels do you see between how “insanity” was weaponized against women in the 1860s and how mental health can still be used to discredit people today?
Dive into the book’s structure, characters, themes, and symbolism.
1. How does Moore balance Elizabeth’s personal story with broader historical context about women’s rights and mental health care? What makes this approach effective or ineffective?
2. Consider the portrayal of Dr. McFarland throughout the narrative. How does Moore’s characterization of Dr. McFarland illustrate the broader themes of power and control?
3. What role does Elizabeth’s writing play in her journey? How does Moore use Elizabeth’s own words to develop her character and advance the narrative?
4. Examine the significance of physical spaces in the book, particularly the contrast between Seventh and Eighth Wards. How do these settings reflect the broader themes?
5. How does Moore use Elizabeth’s relationship with her children to create emotional resonance while avoiding exploitation?
Encourage imaginative and creative connections to the book.
1. If you were to adapt this story for film or television, which aspects would you emphasize? Which characters or scenes would be most crucial to include?
2. Imagine you could write a letter to Elizabeth Packard. What would you want to tell her about how her advocacy has influenced modern society?
3. Consider creating a modern campaign to address one of the issues Elizabeth fought against. Which of her strategies would still be effective today? What new approaches would you add?



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