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Ellen Matsuda and Patricia Matsuda

Ellen Matsuda and Pattie Matsuda are mother and daughter. Their relationship developed through Pattie’s childhood school struggles, her 1998 pregnancy, and their continuing work to understand her access needs.

Overview

Dr. Ellen Patricia Moore Matsuda’s relationship with her daughter Patricia “Pattie” Alison Matsuda was shaped by maternal advocacy, Ellen’s disability-rights expertise, and their responses to repeated crises. Born November 3, 1982, Pattie is Ellen’s third child and second daughter. Pattie was autistic and had ADHD, but only the ADHD was recognized during childhood. Compared with Susie’s gentleness and Joey’s innocence, Pattie’s fierceness, activity, and impulsivity were conspicuous. Her behavior drew frequent school discipline even as she tried to meet expectations designed for neurotypical children.

Ellen, a disability advocate with a doctorate in social work and decades of work against institutional ableism, was repeatedly called to Pattie’s school for behavioral incidents. Her professional expertise helped her secure ADHD accommodations, but it could not prevent every disciplinary response. Ellen watched Pattie internalize the belief that she was “bad” and “broken” despite her mother’s efforts to protect her.

When Pattie became pregnant at fifteen in spring 1998, Ellen drew on her own history of severe pregnancy nausea to support her daughter through similar symptoms. She sat with Pattie through evening vomiting episodes, held her hair back, brought cold washcloths and ginger ale, and did not dismiss the illness with assurances that “it’ll pass.” After Lila’s birth, when the demands of pumping overwhelmed Pattie’s executive function, Ellen framed a switch to formula as a disability accommodation rather than a failure. Her professional advocacy thus informed the care she gave her daughter.

Ellen’s protection and Pattie’s need for validation remained central to their relationship. Their experiences also reinforced the legitimacy of accommodations and of Pattie’s neurodivergent motherhood, particularly when both women were exhausted by successive crises.

Origins

Pattie was born November 3, 1982, Ellen’s third child after Susie (born 1977) and Cody (born 1979), and before Joey (born 1987). Ellen was in her early thirties, already balancing a demanding career in disability services oversight with raising two young children. Greg, her husband, was establishing his career as an educational psychology professor at a university. The Matsuda household was intellectually vibrant, deeply committed to disability rights through Ellen’s Moore family legacy, and structured around the belief that neurodivergence was difference rather than deficit.

From infancy, Pattie was intense, moved constantly, and sought substantial physical and sensory input to regulate. Her high activity and impulsivity became increasingly visible as she entered school, where expectations for sitting still and following directions exposed the extent of her ADHD-related difficulties.

The early mother-daughter bond was complicated by Pattie’s needs and Ellen’s limited time at home. Ellen juggled facility inspections, grant writing, case documentation, and advocacy work that regularly kept her at the office until 9 or 10 PM. Greg’s nightly calls asking “Have you eaten dinner?” reminded her that her commitment to protecting other people’s children sometimes reduced the time she could spend with her own. Ellen nevertheless attended school meetings, ER visits after Pattie’s climbing or jumping injuries, and doctors’ appointments seeking explanations for behavior others called “willful” but Ellen understood as neurological.

During childhood, after Pattie jumped out of a school window “because she wanted to,” she was diagnosed with severe ADHD. The diagnosis came not because educators were particularly attentive to ADHD in girls, which was rarely recognized in the early 1990s, but because Pattie’s impulsivity and hyperactivity were so visible that the school demanded intervention. Her autism remained unrecognized until adulthood.

Ellen fought for movement breaks, fidget tools, modified assignments, and protection from excessive discipline. Pattie’s diagnosis gave Ellen a medical framework for advocacy, but it did not stop teachers and administrators from treating impulsive behavior as willful defiance. Ellen also suspected that ADHD did not fully explain Pattie’s literal thinking, difficulty with social subtext, and rigid responses to perceived injustice. An older account records clinicians dismissing the possibility of autism because Pattie was athletic and popular, made eye contact, and had friends.

An early pattern emerged: Pattie acted impulsively or responded with physical aggression to perceived injustice; schools suspended her; and Ellen attended another meeting about the latest incident. Ellen maintained accommodations and prevented expulsion, but went home exhausted and questioned why she could protect other people’s disabled children more effectively than her own daughter.

Dynamics and Communication

Ellen’s communication was deliberate, measured, and direct, shaped by professional work in which she chose her words carefully. She generally stated what she meant and expected the same in return rather than relying on subtext. This approach suited Greg’s autistic communication patterns and served Ellen in her work, though it created different challenges with Pattie.

With Pattie, Ellen’s directness was both a gift and a challenge. Pattie took language literally and could miss sarcasm or an implied message, so she could trust Ellen’s plainly stated praise. Earlier accounts give “You’re doing well” and “I’m proud of you” as examples of the reassurance Pattie could accept without wondering whether it was social performance. Ellen’s professional sternness—the demeanor she used at work to protect residents from institutional abuse—sometimes made her seem unapproachable to Pattie, who needed validation but struggled to ask for it directly.

Pattie’s communication was impulsive and emotionally reactive. Her emotional dysregulation and rejection sensitivity dysphoria could take her from calm to devastated or enraged within seconds, sometimes without her understanding why. She often spoke before filtering her thoughts, processed aloud, and struggled to adjust her tone or volume to the setting. When stressed or overwhelmed, Pattie sometimes shut down or lashed out physically, making conversation difficult until she had regulated again.

Through professional work with disabled adults and personal experience with Pattie, Ellen learned to recognize when communication was possible and when regulation had to come first. During Pattie’s pregnancy in fall 1998, when she was off ADHD medication and her executive function was impaired by pregnancy and borderline hyperemesis gravidarum, Ellen adjusted her approach. She sat with Pattie through evening nausea episodes, offering cold washcloths, ginger ale, and help holding her hair back during vomiting without demanding conversation or emotional processing that Pattie could not manage.

Practical support became central to their communication during crises. Ellen wrote letters to schools, called doctors, connected people to resources, and attended appointments. For Pattie, who struggled with abstract emotional concepts but understood tangible action, these efforts communicated her mother’s care more clearly than verbal reassurance alone.

During a kitchen conversation in September or October 1998, Tommy Hayes told Ellen and Greg about Evan’s caregiver stress. Evan had been crying in the shower while working six days a week and supporting Pattie through severe pregnancy complications. Ellen listened without defensiveness and recognized that Pattie’s emotional dysregulation while off medication and ill was overwhelming for Evan, despite his commitment to her.

Ellen spoke gently with Pattie about Evan’s burden and helped her understand that his exhaustion was a human limit, not a rejection. She did not blame Pattie for struggling at fifteen while pregnant, off medication, and ill. She also helped Pattie recognize that Evan needed support and that their relationship required mutual care even while Pattie was in crisis.

Cultural Context

Ellen and Pattie’s relationship was shaped by 1990s gender norms surrounding ADHD and autism, the Moore family’s progressive advocacy legacy, and the educational system’s tendency to punish disruptive neurodivergent behavior even after one diagnosis existed.

Pattie’s physical hyperactivity, risk-taking, and impulsive aggression made her ADHD sufficiently visible to be recognized during childhood despite the period’s diagnostic bias against girls. Diagnosis did not translate into consistent understanding. Schools continued to frame her fights, dangerous stunts, difficulty remaining seated, and problems with sustained academic work as choices that stricter discipline could correct.

Ellen used her professional knowledge to contest that framework. She could secure accommodations, cite regulations, and prevent expulsion, but she could not prevent every suspension or stop Pattie from absorbing the repeated message that needing more support meant she was a bad child.

The Moore family’s wealth, whiteness, progressive values, and insistence that disability was difference rather than deficit gave Pattie a safety net unavailable to many neurodivergent girls. When Pattie was suspended, Ellen could cite regulations, demand accommodations, and use her professional authority and connections to prevent expulsion. The family understood that without those resources, a child in Pattie’s position could have been pushed out of education. Pattie’s continued access to school reflected both parental advocacy and class privilege.

Pattie’s pregnancy at fifteen placed her at the intersection of disability, youth, and stigma surrounding teenage motherhood. She absorbed messages that teen mothers were irresponsible, their pregnancies were moral failures, and their children would suffer. Neurodivergence intensified her fear of being judged unfit. Despite Ellen’s reassurance, Pattie believed her ADHD made her inadequate for motherhood. During the pumping crisis, pressure to breastfeed compounded that fear: she kept trying to pump despite the strain because stopping seemed to confirm that she was “broken.”

Ellen’s decision to frame formula as a disability accommodation rather than maternal failure applied the Moore family’s disability philosophy within her own family. In her professional work, she argued that accommodations addressed different needs rather than weakness, and she opposed institutions that withheld support from disabled adults and blamed them for the result. In the hospital, she recognized a similar pattern in the pressure on Pattie to keep pumping when recovery and executive-function demands made the schedule unsustainable. Ellen named formula as an accommodation and affirmed Pattie’s right to choose what worked for her and Lila.

The intervention also addressed the scrutiny placed on mothers’ bodies and choices, particularly those of disabled and teenage mothers. Ellen’s response affirmed that Pattie’s neurodivergence and accommodation needs did not disqualify her from being a good mother. The pumping schedule was not workable for Pattie in those circumstances; changing the feeding plan was a practical decision rather than a failure. The Moore family’s generational advocacy thus extended from institutional work to Pattie’s right to parent without shame.

Pattie’s ADHD diagnosis did not prevent the damage created by repeated punishment. Ellen’s advocacy gave her daughter access to support and a family framework that treated neurological difference as legitimate, even when school responses continued to cast Pattie as a behavioral problem.

Shared History and Milestones

November 3, 1982: Pattie’s Birth

Pattie was born Ellen’s third child, joining Susie, age five, and Cody, age three. Ellen was in her early thirties, already exhausted by the demands of advocacy work and motherhood but committed to both. Pattie’s intensity, constant movement, and impulsivity were visible early.

Age 8–10: ADHD Diagnosis After Window-Jumping Incident

After Pattie jumped out of a school window “because she wanted to,” the school demanded an evaluation. The ADHD diagnosis gave Ellen a framework for pursuing medication and accommodations, though it did not end disciplinary responses to Pattie’s behavior.

Ellen fought for accommodations, and stimulant medication gave Pattie meaningful support with attention and impulse control. Suspensions, behavioral incidents, and calls to Ellen’s office nevertheless continued. At meetings, administrators described Pattie as willfully defiant while Ellen advocated for her as a neurodivergent child.

Elementary Through Middle School: Constant Advocacy

Throughout Pattie’s elementary and middle school years, Ellen was called to school constantly—for fights when Pattie responded physically to perceived injustice, for impulsive acts like climbing structures or leaving class, and for difficulty sitting still or sustaining attention. At each meeting, Ellen cited regulations and IEP requirements to maintain accommodations and prevent expulsion.

These encounters affected both of them. Ellen watched Pattie internalize the belief that she was “bad” and “broken” despite her mother’s professional knowledge and advocacy. Pattie also saw Ellen repeatedly defend her, which reinforced that she was worth fighting for even when she felt flawed.

Spring 1995: Cody’s Suicide Attempt (Pattie Age 12)

When Cody attempted suicide in spring 1995 by overdosing on fluoxetine, years of doctors dismissing his chronic fatigue as “just depression” became part of the family’s understanding of the crisis. Pattie was twelve. She understood that her brother had tried to die but struggled to grasp what that meant for his survival.

Ellen’s attention shifted to Cody during his four-day ICU stay and the months of recovery that followed. Pattie saw Ellen sob beside Cody’s hospital bed. She also watched her parents learn ASL and reorganize family life around his communication needs. Pattie saw that disability accommodations were immediate rights rather than earned privileges, that her family would show up in crisis, and that even a mother who fought institutional abuse could not always protect her child from medical dismissal.

Pattie became more protective of Cody after the attempt and fought bullies with greater intensity. Watching him suffer and recover also showed her that survival was possible after a devastating crisis.

Spring 1998: Pregnancy Discovery (Pattie Age 15)

When Pattie discovered she was pregnant in spring 1998 at age fifteen, she feared telling her parents. She had seen Deborah Hayes attack other pregnant teenagers, absorbed messages that teen mothers were failures, and feared disappointing Ellen and Greg. Ellen’s response centered Pattie’s needs and choices.

Ellen did not demand abortion or adoption. She asked what Pattie wanted, listened to her daughter’s decision to continue the pregnancy, and began providing practical support. Drawing on her experience navigating systems, Ellen helped coordinate medical care and attended appointments when invited. She became part of the support network for Pattie, fifteen, and Evan, sixteen, as they faced parenthood.

Spring–Fall 1998: Hyperemesis Gravidarum and Pregnancy Support

Throughout Pattie’s pregnancy, Ellen drew on her own experience with severe pregnancy nausea and vomiting described as borderline hyperemesis gravidarum. She remembered exhaustion, persistent misery, a sense that her body had betrayed her, and the dismissal of her symptoms as “just bad morning sickness.” She did not minimize Pattie’s suffering.

Ellen sat with Pattie through evening nausea episodes that continued into the second trimester, when they “should have” improved. She held Pattie’s hair back while she vomited and brought cold washcloths and ginger ale. She affirmed that the illness was miserable, was not Pattie’s fault, and was something they would face together. The practical care reassured Pattie that she was neither alone nor failing, and that her symptoms were real.

Being off ADHD medication during pregnancy severely impaired Pattie’s executive function and made basic tasks difficult. Ellen recognized her need for accommodation and helped with organization, planning, and tasks that Pattie could not consistently manage while pregnant and unmedicated.

September–October 1998: Kitchen Conversation with Tommy Hayes

When Tommy came to Ellen and Greg to discuss Evan’s caregiver stress, Ellen listened without defensiveness. Tommy explained that Evan had been crying in the shower while working six days a week and supporting Pattie through severe pregnancy complications and emotional dysregulation while off medication.

Ellen spoke gently with Pattie about what Evan was carrying and helped her understand that his exhaustion was a human limit, not a rejection. She did not blame her daughter, who was doing the best she could under difficult circumstances. She also recognized Evan’s need for support and both teenagers’ well-being, even when doing so meant addressing Pattie’s effect on him before their relationship broke down.

October 24, 1998: Backstreet Boys Concert

Four days before Lila’s birth, when Pattie was 31 weeks pregnant, she attended a Backstreet Boys concert at The Forum with her friend Clarissa. Pattie came home exhausted. Joey, age eleven, feared for his sister’s safety; Ellen and Greg stood with him at Pattie’s bedside so he could see and hear her breathing, then let him sleep on their bedroom floor that night. Ellen was aware that Pattie’s preeclampsia was developing and that the birth might come sooner than expected.

October 28, 1998: Lila’s Premature Birth

When Lila was born nine weeks premature via emergency C-section due to Pattie’s severe preeclampsia, Ellen was at the hospital. Pattie was unconscious under general anesthesia when Lila was born at 8:47 PM, and Ellen was among the family members supporting Evan and the three-pound baby during the NICU stay.

At 10:34 the following morning, Ellen accompanied Pattie and Evan into the NICU for Pattie’s first meeting with Lila. They heard Lila loudly protesting a diaper change before they reached her isolette. Ellen watched through tears as the nurses placed Lila against Pattie’s bare chest. Lila stopped crying and settled beneath her mother’s chin.

October 29–November 1, 1998: The Pumping Crisis

After Lila’s birth, Pattie attempted to pump breast milk from October 29 through November 1. Still off ADHD medication while recovering from surgery, she could not sustain pumping every three hours around the clock. She obtained only drops despite the effort, which intensified her fear that her ADHD made her an unfit mother.

Ellen recognized the familiar pattern: systems set standards without providing needed accommodations and then blamed disabled people who could not meet them. She saw pressure to breastfeed intensify Pattie’s distress as her daughter continued trying to pump under demands she could not sustain while recovering.

November 1, 1998: The Intervention

On November 1, Ellen reframed stopping pumping as a disability accommodation rather than a failure. Pattie could not manage the pumping schedule, and formula allowed her to feed and care for Lila. Ellen’s response gave Pattie permission to choose a workable approach rather than continue suffering under an unsustainable one.

When Pattie gave Lila ready-to-feed formula through her temporary feeding tube for the first time herself, Lila tolerated it easily. Pattie saw that formula met Lila’s feeding needs. Ellen’s intervention also affirmed that accommodations were legitimate, Pattie’s neurodivergence did not make her inadequate, and choosing what worked was an act of judgment rather than weakness.

Public and Private Life

At medical appointments, school meetings, and family gatherings, Ellen often took the role of advocate for her neurodivergent daughter. She cited regulations and accommodations with an authority administrators could not easily dismiss. Her professional reputation as “the Dragon” carried into these encounters: she was stern and unyielding when protecting Pattie from punitive responses.

In public, Pattie tried to meet neurotypical behavioral expectations but was repeatedly disciplined when she could not. Ellen’s repeated defense of her helped Pattie understand that she was worth fighting for even when she felt flawed. Their roles in those settings were often clearly defined: Ellen advocated, and Pattie received that protection.

In private, Ellen expressed exhaustion, worry, and guilt that her expertise had not spared Pattie from shame. Pattie did not have to maintain the same public control at home, where distress could lead to explosive reactions and physical meltdowns. She needed validation but struggled to ask Ellen for it directly.

During Pattie’s evening nausea episodes, Ellen held her hair back while she vomited, brought cold washcloths, and stayed with her without judgment or platitudes. This private care reassured Pattie that her mother would remain present through the difficult physical realities of disability and pregnancy, as well as advocate for her in public.

The pumping crisis unfolded in the hospital and at home, away from public scrutiny. By framing formula as an accommodation rather than a failure, Ellen placed Pattie’s mental health and Lila’s well-being ahead of pressure to breastfeed.

Emotional Landscape

Ellen’s fierce, unconditional love for Pattie was complicated by the limits of her professional knowledge at home. She saw Pattie struggle with systems Ellen challenged at work and internalize shame that her advocacy could not prevent. Ellen also felt guilty that the demands of that work sometimes kept her away from her children.

Ellen took pride in Pattie’s protectiveness of Cody, her courage in facing teen motherhood, and her care for Lila despite exhaustion. She also grieved the childhood Pattie might have had if schools had consistently accommodated her ADHD rather than punished its most visible manifestations.

Pattie loved Ellen but needed her validation and feared disappointing a mother who fought for others. She knew Ellen was proud of her yet struggled to accept that pride, convinced she was “bad” and “broken” despite Ellen’s advocacy. At school meetings, Pattie felt grateful for her mother’s protection and ashamed that she needed it.

Pregnancy intensified Pattie’s need for Ellen’s validation. Off medication, physically miserable, and frightened of motherhood, she relied on her mother’s practical support and understanding. Ellen’s care during the evening nausea episodes helped Pattie trust that her mother would neither leave when circumstances became difficult nor dismiss or blame her for struggling.

The pumping crisis made Ellen’s advocacy personal for both women. By framing formula as an accommodation, she affirmed that Pattie deserved practical support in her own life and that neurodivergence did not make her an inadequate mother. For Pattie, that lesson was deeply emotional and changed how she understood Ellen’s work and her own needs.

Health and Access

Ellen’s professional expertise in disability services directly shaped her approach to Pattie’s neurodivergence and medical needs. She fought for ADHD accommodations in schools and consistently framed Pattie’s struggles as neurological rather than willful misbehavior. She suspected autism for years, but clinicians dismissed the possibility because Pattie did not match their expectations of an autistic girl. Pattie’s later diagnosis gave language for needs and traits the childhood assessment had missed. Ellen’s professional knowledge also showed her how limited a diagnosis could be when schools treated accommodation as optional and discipline as the default.

Pattie’s childhood ADHD diagnosis provided a framework and medication that improved her impulse control and attention. Ellen also advocated for movement breaks, fidget tools, and modified assignments, fighting schools that wanted to treat Pattie as a disciplinary problem rather than a disabled child needing support.

During pregnancy, being off ADHD medication severely impaired Pattie’s executive function. Ellen recognized her need for accommodations and helped with organization, planning, and tasks Pattie could not manage consistently. She understood this support as a practical response to pregnancy and unmedicated ADHD rather than indulgence.

Ellen’s own history of severe pregnancy nausea and vomiting, described as borderline hyperemesis gravidarum, helped her understand Pattie’s symptoms. She remembered having severe, prolonged symptoms dismissed as “just bad morning sickness” and being told they would pass. She took Pattie’s debilitating nausea seriously and did not repeat that dismissal.

The pumping crisis brought Ellen’s disability advocacy directly into her daughter’s care. She saw that pressure to breastfeed compounded Pattie’s executive-function difficulties and that formula would allow Pattie to meet Lila’s needs without an unsustainable pumping schedule. Ellen’s reframing—“This is disability accommodation, not failure”—gave Pattie permission to choose what worked.

The intervention reflected Ellen’s professional belief that accommodations were legitimate supports rather than moral failures. She had spent decades challenging systems that demanded disabled adults meet neurotypical standards without support and blamed them when they could not. With Pattie, she applied the same principle at home.

Crises and Transformations

Spring 1995: Cody’s Suicide Attempt

Although Cody was the patient, his suicide attempt and four-day ICU stay affected the entire Matsuda family, including Ellen’s relationships with her other children. Her professional sternness gave way to grief as she sobbed beside Cody’s hospital bed. She decided immediately that the family would learn ASL and faced guilt over having trusted a doctor who dismissed Cody’s suicidal ideation.

Pattie found Ellen’s vulnerability both frightening and humanizing. She saw that her mother, known as “the Dragon” for her advocacy, could grieve and could not prevent every harm despite her expertise. Ellen demanded AAC for Cody from the first day, without waiting through months of unsuccessful speech therapy. Pattie understood from the crisis that communication accommodations were immediate rights, even though a determined parent could not prevent all harm.

Spring 1998: Pregnancy Discovery

When Pattie discovered she was pregnant at fifteen, she feared the revelation would damage her relationship with Ellen. Instead, Ellen asked what Pattie wanted, supported her decision to continue the pregnancy, and offered practical help without shaming her. Pattie remained her daughter and deserved support and protection.

Spring–Fall 1998: Hyperemesis Gravidarum

Pattie’s severe pregnancy nausea from spring into fall 1998 tested both women’s endurance. Because Ellen had experienced similar symptoms, she could take Pattie’s suffering seriously, sit with her during evening vomiting episodes, and provide practical comfort.

The sustained illness added hands-on care to a relationship already shaped by Ellen’s advocacy at school. Pattie learned that Ellen would help during physical distress at home, including late-night vomiting, as readily as she would appear at an official meeting.

October 28, 1998: Lila’s Premature Birth

Lila’s emergency delivery nine weeks early because of Pattie’s severe preeclampsia was a serious medical crisis. In the NICU the next morning, Ellen saw Lila stop crying when nurses placed her on Pattie’s chest. Ellen understood their contact as evidence of a strong maternal bond that was not diminished by Pattie’s age or neurodivergence. It also affirmed her belief that teenage neurodivergent mothers could parent successfully with support.

October 29–November 1, 1998: The Pumping Crisis and Intervention

Across three days, Pattie tried to pump milk while off ADHD medication and recovering from surgery. She obtained only drops despite around-the-clock effort. The experience intensified her fear that ADHD made her inadequate as a mother.

On November 1, Ellen framed formula as a disability accommodation rather than a failure. For Pattie, this changed how she understood her neurodivergence: ADHD meant she needed different supports, not that she was an inadequate mother. Choosing a workable feeding plan was a sound decision rather than weakness.

The crisis also made Ellen a source of self-acceptance for Pattie as well as protection. Pattie recognized that the accommodations her mother fought to secure for others were also her own right.

Legacy and Lasting Impact

Ellen’s advocacy conveyed to Pattie that she was worth fighting for, that accommodations were legitimate, and that neurodivergence was difference rather than defect. Each school meeting, contested suspension, and maintained accommodation reinforced Pattie’s right to support even when others labeled her “bad” or “broken.”

Ellen’s support for the formula switch shaped Pattie’s later understanding of disability accommodation. It helped her approach parenting, self-care, and managing her neurodivergence with the belief that practical support carried no shame and did not imply inadequacy.

For Ellen, the relationship held both achievement and painful limits. She advocated for Pattie’s accommodations, supported her through teen motherhood, and affirmed that neurodivergent mothering was legitimate. Yet she could not prevent Pattie from internalizing shame during childhood or fully shield her from the systems Ellen challenged professionally.

For Lila, the relationship provided an example of intergenerational support. She grew up seeing Ellen respond to crises with practical care and advocacy, support Pattie’s neurodivergent parenting, and treat accommodations as ordinary and necessary rather than shameful.

Ellen’s disability advocacy became personal through her relationship with Pattie. Their history showed that obtaining one accurate diagnosis did not guarantee either a complete assessment or adequate support; even experts could struggle to protect their own children when schools treated neurodivergent behavior as a disciplinary problem.

Pattie carried this approach into parenting Lila, building accommodations into family life and trying to prevent her daughter from internalizing the shame Pattie had experienced. She also carried forward Ellen’s belief that disabled people, including Pattie herself, deserved dignity, autonomy, and support without apology.