This chapter analyses the messy impact of historical forces such as ableism, patriarchy, and institutionalization on Ott’s life. The justifying logic imbedded in her diagnosis and prescriptive institutionalization (re)wrote her life story—her past, her future, and how she would be remembered. The ableism undergirding Ott’s insanity diagnosis permeated legal, familial, and activist contexts both outside and inside the walls of medicine in the late nineteenth-century United States. The chapter then argues for biography as a powerful methodology to forefront lived experiences while simultaneously embedding those lived experiences in large-scale social and historical structures.