Content Warning: This section discusses violence and abusive behavior toward, and mistreatment of, women and people with disabilities and mental health conditions.

Nellie Bly opens by explaining that her account of Blackwell’s Island Insane Asylum was first published in the New York World and received widespread attention, prompting numerous requests for copies even after the initial edition sold out. This public demand led her to publish her experiences in book form. Bly proudly notes that her investigative work resulted in the City of New York allocating an additional $1 million annually to improve the care for those with mental health conditions, ensuring that future asylum patients would receive better treatment.

Bly recounts her decision to undertake an undercover assignment for the New York World, where she would feign “insanity” to gain admittance to a New York asylum and report on its conditions. Although unsure of her ability to convincingly impersonate a person experiencing delusions and nervous about the challenges she would face, Bly was determined to complete the mission. She carefully planned her approach, choosing not to involve friends or doctors to avoid complications and to preserve the authenticity of her investigation.