"How can a doctor judge a woman's sanity by merely bidding her good morning and refusing to hear her pleas for release? Even the sick ones know it is useless to say anything, for the answer will be that it is their imagination"

Nellie Bly exposes the injustices and inadequacies of mental health care in her era through her sharp critique of psychiatric authority. She points to the fundamental flaws in how doctors assess the mental state of women, emphasizing the superficiality and indifference embedded in their methods. By referencing a doctor who judges a woman's sanity based solely on a brief, routine interaction like "bidding her good morning", Bly highlights the lack of meaningful engagement or genuine evaluation in these encounters. The doctor’s refusal to listen to the woman’s own account of her experiences further demonstrates the power imbalance and the silencing of voices presumed to be irrational or untrustworthy simply because they belong to institutionalized women.

Bly's words reveal how the professional's authority is exercised not through compassionate care or rigorous inquiry, but through dismissal and neglect. The system is shown to be self-perpetuating: once labeled as mentally ill, anything a woman says is quickly invalidated as "her imagination". This creates a profoundly disempowering atmosphere, where patients understand that their protests or rational arguments are futile since their perspectives will always be pre-judged as symptoms of insanity rather than possible truths. Even those women who are genuinely suffering, she notes, comprehend the uselessness of voicing their needs or perspectives.

The passage effectively underscores a much broader critique of patriarchal and institutional power. By centering the passive yet absolute authority of the doctor, someone who can determine sanity or insanity at a glance, Bly exposes how systems can perpetuate injustice by refusing to treat those in their care as fully human. Emotional suffering and requests for help are not just overlooked, but transformed into proof of illness. The desire for release, sanity, or justice is denied not because of careful diagnosis, but because of a systemic refusal to listen. In doing so, Bly's testimony calls for empathy, reform, and recognition of the voices and dignity of those most vulnerable to institutional power.