This was probably a 5 star book back when it was written but its setup, an unreliable possibly insane narrator, is now such a familiar trope that it is hard to appreciate in the 21st century. Let me try to contextualize it.

At the time it was written, medicine was in a primitive state. The germ theory of disease was new and not universally accepted, anesthesia was a recent invention, Freud was an unknown and mental illness a mystery. When now we visit a doctor, we do so believing they have skills that have been tested scientifically, but at the time this book was written, a doctor's authority was based more on his cultural standing than his ability to relieve suffering through more than the placebo effect (which is not to be minimized!) The idea that a so-called mental patient could have anything to say for themselves is, remarkably, still controversial today.

We have replaced the "outmoded" religious/moral critiques of behavior with those we believe to be scientific but often the term "healthy" is just a pseudo-objective value judgement reflecting the behaviors our culture finds acceptable. The most accepted treatment of the non-mentally healthy is either to drug it away or to convince the patient that her behavior is irrational and convince her to behave otherwise for her own good. It wasn't that long ago that we condemned the Soviet Union for locking their political dissidents in mental hospitals but we in the West today differ more in degree than in kind.

I say this because it is easy to dismiss the narrator's husband as "the oppressor" but he was merely going along with the accepted treatment of the time, something called the Rest Cure, which made as much sense as many other contemporary medical practices. It's not he, but society as a whole which is her oppressor, something which will in a later age be called "The Patriarchy."

Whatever else you may think of Freud, he understood that his patients had things to say about their condition that made sense if not always taken literally. Incidentally, Freud was also the first to suggest that men could suffer from "hysteria."

We listen to the narrator sympathetically, which no one else in the story attempts to do. We empathize because we know how it feels to be humored and judged and like the narrator, we internalize some of this judgment and see ourselves at fault. She is a prisoner, supposedly for her own good, and even she doubts that her evaluation of the situation is correct. Her powerful description of her own plight told symbolically through the pattern of the yellow wallpaper (which she knows is not part of consensus reality and thus must be kept secret from the others--so much for being out of touch with reality) is beautifully done, better than so many of Gilman's countless imitators.

Written at a time when women weren't listened to and read by me at a time that women are listened to, but only if they talk and act like men,