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She graduated from the College of William and Mary in 1964. From 1964 to 1968 she was a public school teacher in Virginia. She married James Brady in Alexandria, Virginia on July 21, 1973. On December 29, 1978, their only son, James Scott Brady, Jr., was born.
From 1968 to 1970 she worked as assistant to the campaign director for the National Republican Congressional Committee. She then worked as an administrative aide, first for Mike McKevitt (R-CO) and then for Joseph J. Maraziti (R-NJ). From 1974 to 1978 Sarah Brady worked as director of administration and coordinator of field services for the Republican National Committee.
Her husband sustained a permanently disabling head wound during the Reagan assassination attempt which occurred on March 30, 1981. James Brady remained as Press Secretary for the remainder of Reagan's administration, but this was primarily a titular role.
Alongside her husband, Sarah Brady became "one of the nation's leading crusaders for gun control". They later became active in the lobbying organization (named Handgun Control, Inc.) that would eventually be renamed the Brady Campaign to Prevent Gun Violence.
Despite her support for gun control, she bought her adult son a hunting rifle as a Christmas present. The New York Daily News suggested she may have "skirted" Delaware's background-check requirements for gun purchases.
In 2002, Sarah Brady and Merrill McLoughlin wrote A Good Fight, published by Public Affairs. The book is about her entire life, including a recent battle with lung cancer. According to Library Journal, it is more about her personal battles and her determination and courage than about gun control. In April 2002, Court TV announced a planned TV movie adaptation of the book, to be produced in conjunction with Hearst Entertainment. At the book's launch, Bill Clinton praised her for having "given the gift of life to countless thousands and thousands of Americans".
According to Publishers Weekly it gives an "intimate" look at her public and personal life, including a "detailed, suspenseful account" of the efforts to pass the Brady bill.
Kirkus Reviews called it "spirited", "cheerful and even homey", portraying Sarah Brady as a "scrapper" who never gives up, despite her husband's injury, her son's medical problems, and her own battle with lung cancer caused by her heavy smoking.
The Weekly Standard, a conservative publication, found it left unanswered questions, being almost silent on the topic of firearms and making unsupported claims about how many Americans agree with her campaign.