In this article, I address the embroilment of medical science in the lifeworlds of the urban poor in Brazil, particularly the place of psychopharmaceuticals within households. I explore how psychiatric diagnostics and treatments are integrated into a domestic “dramaturgy of the real” and how family members use them to assess human value and to mediate the disposal of persons considered unproductive or unsound. I focus on the life of Catarina, who was deemed mad and left by her family in an asylum in southern Brazil. Disabled and abandoned, Catarina began to compile a “dictionary” of words that have meaning for her. By tracing Catarina's words back to the people, households, and medical institutions that she had once been a part of, I illuminate the complex network in which her abandonment and pathology took form as well as the edges of human imagination that she keeps expanding. From this examination, one comes to understand how economic globalization, state and medical reform, and acceleration of claims over human rights and citizenship coincide with and impinge on a local production of social death. One also sees how mental disorders gain form at the juncture between the subject, her biology, and the technical and political coding of her sense of being alive. Hers is not just bare life, though: Thinking through her condition, Catarina anticipates social ties and one more chance. This is also a story of the methodological and ethical challenges I faced as I supported Catarina's search for consistency and her demands for continuity.