|“||David hasn't told you? Az and I come from the same city as you. If we'd stayed we might have been ones to turn you pretty.||”|
Maddy was born in Tally's city and became a cosmetic surgeon as a middle-Pretty, eventually joining the Committee for Morphological Standards, more commonly known as the Pretty Committee. She soon met and fell in love with Az, a surgeon, and they eventually got married.
One day, the couple discovered the lesions found only in Pretties' brains and began to research them, finding out that only Pretties with jobs requiring quick-thinking were free from lesions. They concluded that the lesions were an intentional part of the Pretty Operation. Special Circumstances soon shut down their research and ordered them to forget about the lesions, threatening to take away their licenses.
They soon had a son, David. Curious about the city his parents came from, David probed its borders and met more tricky Uglies wanting to explore the world. He told them about his home and acted as a guide for many such Uglies, bringing them safely to the Smoke.
- Main article: Uglies (book)
Maddy and Az live somewhat apart from the rest of the Smoke, preferring to live quiet lives. David eventually introduces a new Smokie recruit, Tally, to his parents. Impressed by her, they explain the secret of the Operation's lesions over a cup of tea.
Maddy and Az always thought that Special Circumstances might find them one day, and so carefully prepared a hidden cave filled with supplies in case they ever needed to run, teaching their son what to do if they're invaded.
Their paranoia turns out to be fortuitous after Tally accidentally sets off her pendant's tracker. Special Circumstances arrives within hours and find Maddy and Az, kidnapping them and setting fire to their home. As the house is built into the side of a mountain, the Specials throw an explosive through the window and blow it out from the inside.
Back at Special Circumstances Headquarters, Dr. Cable worries that Maddy and Az have known about the lesions and the Smoke for too long, meaning that they may still remember it all even after the Pretty Operation. She decides to try out an experimental brain surgery meant to modify their memories, but the risky procedure accidentally kills Az. David and Tally manage to rescue Maddy before the surgery is performed on her, but the death of her husband devastates her, and she can't help but blame Tally.
As the rescued Smokies hide out in the Rusty Ruins, Maddy works on a cure for the Pretty lesions. Unfortunately, she has no willing test subject to try them on. Tally, who feels horribly guilty about her husband's death and the destruction of the Smoke, volunteers to give her informed consent, get captured, and made Pretty so that she can test the experimental cure.
- Main article: Pretties (book)
Special Circumstances begins to sweep through the ruins more thoroughly than ever before, forcing Maddy and her Smokeys to relocate. They eventually find an old observatory that becomes their new base of operations. Maddy gives each of the Crims the cure once they escape the city and does her best to heal Zane's brain damage, but can't do much more than regenerate the destroyed tissues of his brain using stem cells. She explains that the vanished neuron connections in those damaged areas store memories and motor functions, but it's possible for him to make more connections.
Although she's impressed that Zane lasted so long, she's even more amazed that Tally's cured at all. It appears as though Tally managed to think her way around the lesions, which opens up possibilities for an improved, less dangerous cure.
Unfortunately, not much time passes before a tracking signal goes off, broadcasting the New Smoke's location. Maddy and the Smokeys frantically scan everything they have in an attempt to find the signal's origin, but its Tally who realizes that the tracker is inside Zane's tooth. He had been having awful toothaches ever since he reached the Smoke, and Tally remembers that he had gone to the hospital for a broken hand two weeks before, where Specials must have also implanted a tracker in his tooth. Sure enough, the signal is coming from his mouth.
Maddy rushes over to see what she can do, but the tooth is rooted to the bone and impervious to damage. Out of options and out of time, the New Smoke is forced to leave Zane behind. Tally chooses to stay with him to David's distress, but Maddy urges him to let the selfish, pretty-headed Tally go. At some point, she had warned her son not to lose control of his emotions and become awestruck at Tally's new, Pretty face.
- Main article: Specials (book)
Maddy's new cure is spreading farther and faster than ever thanks to her studies of Tally. Instead of eating away the lesions, it helps Pretties' brains think around them, making it much safer and quicker. The New Smoke's new home base, the city of Diego, is doing its part by mass-producing the cure and lending out its helicopters to pick up runaways from all over the continent.
After the war, she sends a ping to Tally stating that David has left Diego and that if she sees him, to tell him that his mother loves him. The Smokies are planning to spread the cure to the southern and eastern continents, smuggling the cure into the cities that still cling to the bubblehead operation. She lets Tally know that she's welcome to help liberate the world, if she wants to join them.