Is the narrator insane at the beginning of the story, or does she become insane at some point during the narrative?
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The narrator starts out pretty sane. She is aware that much of her suffering is caused by the patriarchal ignorance of her husband and the medical establishment. Unfortunately, she has no way to fight back. I would say she becomes “insane” after being locked in the room and completely identifying herself with the woman imprisoned in the wallpaper.