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To me, the main idea of this story is that a person's attitude is what matters the most in life.
In the story, Johnsy is dying largely because she thinks she is dying. When her roommate tries to reason with her and treat her like an adult, Johnsy continues to fade toward death.
But when the old man paints the leaf on the wall, she becomes convinced that she is not going to die after all. Objectively speaking, nothing has changed. But she has convinced herself that she can live where before she had convinced herself that she would die.
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