Monday, June 27, 2011

Casebook - Patient: Alice

Here's another Alice related post. This was an extra in the original release of American Mcgee's Alice, however, EA did not see fit to digitize it and include it in the release of Alice: Madness Returns. This was transcribed by Lsnake/Engelen for his faq. It basically reads like a journal by Alice's doctor when she was in the asylum. Enjoy the read, it adds a good deal of depth to the story.

4 November 1864

Received Confirmation from the superintendent that I will be given
the opportunity to treat a very troubled and difficult patient. Dubious Honor!
Her name is Alice, and her prognosis is not promising. After looking at her
file, I'm astonished she has survived this long. She has been nearly comatose
for a year.

"Would I have admitted her had I known then what I know now?" -3/10/73

11 November 1864

Mute on a stretcher, with her head curiously bandaged, Alice seems to cling
precariously to life. Her burns have healed remarkably in the year since the
fire, but she languishes in a deep trance-like dementia. It's as if the blaze
consumed her senses wholesale. Deaf, dumb and blind to all stimulation, she's
a fair match for the infirmary's gloom.
In a frenzied instant, a cankered feline pounced on Alice while she was about
to be carried inside. Startled by the cat's yowl, the bearers lost their grip
and dropped the wretched girl to the ground. Most curious to behold, the cat
stood atop Alice as if claiming territorial right, or as if defending a rodent
captured in the day's hunt from other hungry predators. Only when an orderly
threatened it with a stick did the creature scamper into a nearby hedge. Even
then the cat crouched beneath the shrubbery. With eyes agape, it fixed on
Alice as if it had some vital interest in our proceedings.

"It pays to heed the feline--something I've learned over the years." -21/10/73

14 November 1864

Her one possession is a toy--a sooty, stuffed rabbit whose single button-eye
dangles from a loose thread. Plaything from her time of innocence, and her only
link to life before the fire, the rabbit is now sentinel to Alice's deepening

"The rabbit may prove a valuable instrument for shock terapy. I should have
noticed it sooner" -21/10/73

8 December 1864

When I hold a flame to her eye, nothing in her vacuous gaze berrays the
faintest glimmer of response. I clap a pair of blocks at her ear. Nothing.
Neither her sight nor her hearing appear to be damage, still she registers
nothing at all. The rumor (passed on by Reverend Mottle amongst others)
alleges that she feels nothing--not pain, or fear or other torments--is neither
credible nor kind. Still, she is far, far gone, this one.

10 December 1864

Though she appears weak, she must have a strong constitution to have survived
until now. Her fever persists, her breathing heaves violently at times and,
even after more than a year of healing, burns so massive commonly cause great
discomfort. You'd never imagine she's in any distress, though, the way lies
there, as lifeless as a British Museum mummy. I daresay, however, that I'll
stir her from her dreamery, even if the response is involuntary.
I'll begin tomorrow with a steady treatment of cold plasters and bloodletting.
The bleeding might cause some relief to her dementia. I also have a new shock
apparatus that I'd like to try on her. I'm curious to see how she reacts to
this treatment.

6 January 1865

Another patient died in the night. I'd been treating her with the same potion
I intend for Alice. I had been quite certain she was improving with each
subsequent vial, so this development is quite vexing. Perhaps the stronger
mixture was too much for her chronically weak chest. A little more
experimentation is in order before I feed this serum to Alice.

"A little less laudanum and a little more camphor might have
spared her" -13/12/73

23 February 1865

Through the windows of my laboratory, I can glimpse the garden ward. Nurse D-
is leading a group of children to the airing room. I listen to great shuffling
of feet on the pebble path. Will Alice, I wonder, ever stroll the grounds with
the others? Will she ever regain her senses? Or, for the rest of her days will
she remain cloistered behind these thick, gray walls? Based on her progress
so far, it seems futile to hold out much hope for a cure.

"Little could I have imagined her mind would eventually gambol in
unimaginable forests and gardens" -27/1/74

23 March 1865

Nothing seems to aggravate the girl. I've tried restraint--handcuffs, leg-locks
and straitjackets. I've tried solitary confinement. On the other hand, I've
allowed her to smell freedom, leaving her for hours at a time unattended in
the garden. Yet nothing stirs her. I still have a number of methods, some of
which I haven't engaged in since the old days, but I'm beginning to doubt
anything can bring about a change in this one.

1 April 1865

Each year on this peculiar day I pause--exactly at noon according to my pocket-
watch--to ponder the absurdity of such a day. Is it not ironic that we here
should celebrate a holiday dedicated to fools?
The girl has shut down completely. If it were possible, I'd say Alice has
retreated even further into what the European practitioners of psychiatry call
her "psyche". I'll keep trying different methods, but unless there's some sort
of marked improvement, there's no reason to hope. I'll document progress...if
indeed there ever is any progress.

7 September 1873

After years of slumber, she chooses to speak to use with a picture, a drawing
of some sort of cat. Really, though, it's nothing like any cat I've ever seen.

"Even a drawing so bizarre couldn't foreshadow the imaginings to come"

10 September 1873

While Alice napped following her afternoon sedation, Nurse D- took it upon to
replace the rabbit's missing eye. Even after living so many years in an infirm
population, it can still surprise me when a seemingly trivial act can trigger
such a remarkable reaction.
Alice woke from her nap and began to sob hysterically.
"Tell me, child, what's wrong?" pleaded Nurse D-.
"What is it, dear?"
In an instant of semi-awareness, Alice spoke a sort of poetry.

"Into the hole again, we hurried along our way
Into a once-glorious garden now seepd in dark decay"

She continued to cry, and it was only when Nurse D- plucked the newly stitched
eye from the rabbit's face that Alice fell back into her customary state.

"With such behavior, maybe it was a mistake to stir these waters and
awaken her" -29/3/74

I don't know whether to cheer at this response--any response--or grow alarmed
over the intensity of her emotional outburst. At least we discovered one thing:
She can speak.

11 September 1873

When she is so inclined, Alice can draw. This morning I was greeted by another
of Alice's artistic phantasmagorias. What is it she's rendering? I can only
think it's a depiction of her nightmare of Hell.

15 October 1873

Approaching Alice's room, I heard the muffled sounds of laughter. A pair of
orderlies were cursing at her and threatening her with leather straps. It's
easy to see that this pair was weaned from the same teat.
Alice didn't respond to their tomfoolery; and the orderlies were not impressed
by my reprimand. Good help is so hard to find.

18 October 1873

The Superintendent paid a visit. The smell of his perfumed handshake is still
in my nostrils. He doesn't visit often, but when he does he arrives unannounced
and remains overlong. Typically, he flounces through the infirmary pretending
to be interested in this case or that. This time, he requested to see Alice and
asked for the leeches. When she refused to stir, the Superintendent stretched
wide his mouth in a yawn of infinite boredom.
When I displayed some of her recent artwork, the Superintendent's attention
was caught again as if someone jabbed his fatty palm with a hot poker.

"He was in a very agitated state when he departed" -7/4/74

24 October 1873

Nurse D- has been listening from outside the door. Alice, it seems, has been
muttering inarticulately. Though no one can understand her, it's likely she's
addressing the one-eyed hare.

26 October 1873

Her case is not overly least not when compared to the countless
other patients who live within these walls. I am not minimizing her tragedy--
the undeniable strain is enough to set anyone's mind askew. Imagine the horror
of hearing the piteous cries of your entire family--trapped in their burning
bedrooms--and being unable to help. Alice certainly heard such screams. I
imagine she's been hearing them for ten years.

"Looking back, I retract this statement. Her case IS most remarkable" -7/4/74

3 November 1873

I hear the clock ticking onward, past midnight, and then I'm suddenly aware of
other sounds. In the barren pit of the night, the most disturbed minds are
alive throughout the asylum. Alice isn't stirring, so I listen to the blood-
curdling shrieks, the haunting clank of shackles, the insane groaning,
insufferable babble and lunatic mutterings.
After the initial convulsions, Alice's body again appears lifeless. If it
weren't for the for the sporadic utterances in her sleep, I'd hold the mirror
to her mouth. It's impossible to comprehend what she says. It sounds like
"too glum" or "through him" or "boo-jum". Nonsense really. Is it a person's
name? A place? Or simply some conjuring of this raving delirium? I yell the
utterance into her ear and prick her shoulder with a needle--she gasps, but
her speech does not become any clearer.

"Boojum! But how does she construct such fantasies?" -11//4/74

The potion courses through her blood. Sitting in this cold room reminds me
of the last treatment here. The shredded padding recalls to my mind the patient
who believed rats spoke to him--they lived in the padding, he said. Indeed,
he believed the spirits of his ancestors spoke to him through the rats. After
the trepanation, he stopped having such delusions and was removed to the
Alice remains quiet.

21 November 1873

Once again, the orderlies were up to their usual pranks. Weary of prying open
Alice's mouth, the orderlies started "feeding" Alice's toy rabbit, spooning
porridge onto the stuffed toy.

"My suspicions are confirmed. Those oafish orderlies are the Superintendent's
misbegotten nephews" -13/4/74

While engaged in this feeding, the orderlies learned an essential lesson in
asylum protocol--never turn your back on a matter how docile she
seems. From information I've gathered, Alice woke from her comatose state and
attacked the orderlies. Quite venomous in her outburst, she pursued one of the
twins with a spoon. Even in her condition, she was able to deliver quite a
gash. She clutched the spoon like it was a butcher knife, gouging into his
fleshy cheek. Ceasing in mid-attack, she turned the spoon on herself, digging
it into her wrists, trying to open up her veins. I stitched her wounds and
tended to the orderly. Alice shouldn't suffer any permanent physical scars,
it's too early to say the same about the orderly.

"An outburst such as this shouldn't have surprised me" -13/4/74

She has returned to her dormant state. Nothing I say or do can entice her to
relive her early morning animation.

7 December 1873

Here's been a slight change. Her mouth is now relaxed, and we can feed her
without force. When it's time for her elixir, she seems to part her lips
slightly as if she's inviting the new potion into her belly.
Hardly a cure, but any change symbols progress.

8 December 1873

A mangy cat was licking at Alice's cheek. It hissed when I entered, and pounced
onto the windowsill--it must be flesh and bones only to squeeze through the
grate. I could almost perceive a smile on its scabbed face. It's curious how
an animal's countenance can appear almost human.
There are so many feral cats on the grounds. I wouldn't be surprised if they
outnumber the patients.

"It reminds me of the cat that pounced on Alice when she arrived here. More
emaciated though." -26/4/74

13 December 1873

Something in the outdoor air may have stirred he imagination. On her return
she produced an intriguing sketch. Once again she proves she is capable of
doing something other than staring at the yellowed paint on the ceiling.

"At times there's talent in her madness" -26/4/74

15 December 1873

It's been three days since I removed the rabbit from her room. We can hear her
screams growing louder through the closed door.

25 December 1873

She has returned to her trance-like state, with one notable exception--her
mouth stretches very wide whenever anyone enters the room. Whether it's for
the potion or for the food, she's definitely inviting more.

"What she means by repeatedly whispering "Eat me" and "Drink me" still
eludes me" -23/7/74

17 April 1874

Months pass and still nothing.
Nurse D-, having lost patience with my treatments, insists on trying a "cure"
of her own. She stiched the rabbit together and tucked it into bed with Alice.

18 April 1874

Interesting development! Alice has returned the gift, presenting Nurse D- with
a drawing of a rabbit, though it's quite different from her toy.

"My watch?" -10/5/74

1 June, 1874

Out of nowhere, and as shocking as a bolt of lightning across a sky of purest
azure, Alice greeted me with a strange grin. And then, lightning bolt upon
lightning bolt, she began to converse quite freely as if we'd been speaking to
each other like this for decades. I'll include just a smattering of remarks
as evidence, not that the burden of proof is with me in this foul courtroom.
"Beware the Snark's poisonous spit...roll the Demon Dice wisely or the game
turns on you...note the Centipede has a tender underbelly...I enjoy the taste
of mushrooms, but not the ones that bite back."

Regrettably, I cannot regard this maniacal outpouring as an improvement in
her condition.

2 June, 1874

It's a world of sheer, chaotic terror and unmitigated bloodshed--that's the
world she inhabits. So severe are her delusions, so fantastical and absurd,
that at times it's difficult for me to listen. She speaks of a nightmare realm
where everything seems bent on her destruction. Gigantic Bayonet-toting ants
and flesh rending flowers. Carnivorous fish and fire-spewing abominations.
The range of hellish creatures populating her world is dizzying. They are, on
balance, more deranged than the most demonic triptych Hieronymus Bosch ever
It's as if I have been waiting and waiting for water to pour from a spigot.
Now, the water has finally started pouring, and I cannot staunch the flow, nor
discover its poisoned source.

7 June, 1874

More and more, she confides in me. She drones on and on. I think the elixir
is at the proper dosage now. At times, she seems to fear and loathe my
presence, yet she speaks as if she can't help herself.

8 June, 1874

She spent the afternoon telling of a grisly siege between life-size chess
pieces. Having been hounded by a cyclopic pawn, it seems she dispatched the
one-eyed monster only to be chased mercilessly over the living chessboard by
a pair of renegade rooks. as usual, her description was vivid beyond
comprehension, a story decidedly more compelling than anything in Froissart's

11 June 1874

Dozing off for a few minutes only, I woke to the sight of Alice's freed hands
tugging at my watch fob. Shackles might be required for future sessions--at
least until she behaves. I'm taking her pencils as well. Let's see if this
punishment provokes a response.

12 June 1874

I should have predicted this. without pencil, she turns to poetry.

"Mange-ridden to the core, he leads me through the fray
With the toss of a Jackbomb, I clear abominations from our way"

I asked her to describe a "Jackbomb". Cunning and clever girl, she
asked me to return her pencil.

15 June 1874

Her conversation contains flashes of lucidity. Certain powerful words, however,
cause her to dip back into her fantasy world. And a word like "fire" can, for
obvious reasons, set her tumbling into an abyss of sadness.

"Her conversations can be clear, but her drawings show no such progress."

17 June 1874

Alice hurled the teapot across the room.
"How many times must I tell you? I only take tea with friends!"

18 June 1874

At times, she can be quite civil, and sometimes disgustingly vile. As an
experiment, I've decided to suspend all medication, except for a heavy dose of
laudanum when she's in the foulest of tempers.

25 June 1874

Perhaps more cold saltwater treatments will cleanse some of the chaotic
thinking from her mind. She has been ranting. In particular, she's been
spouting violently against someone she refers to as the Red Queen.

"Though the Queen dominates much conversation, Alice refuses to describe or
draw the monarch. Her anger, though, knows no limit when she talks about
what she'd like to do to the Queen." -20/7/74

19 July 1874

In her most disturbing outburst in quite some time, Alice attacked one of the
nurses while being bathed. Called her "Duchess".

22 July 1874

From a recent conversation with Alice:
"What have you been doing, Alice?"
"Attending the tea party of course."
"Was it a grand party?"
"Oh most grand, dear doctor. I fear nothing and soon the Keep will be in

25 July 1874

Her sleep is very restless one night, and then calm as an infant's the next.
She's become consistently unpredictable.

27 July 1874

Alice delivered another verse to her puzzling rhyme.
"They taunt me about the burning as if I were to blame,
I clear them from my conscious with the eloquence of my blade"

28 July 1874

She spoke at length of a place called the Fungiferous Forest. It's a place
filled with mushrooms the size or large trees; fungus and foliage that grabs
those who trample it; cavernous wastes filled with creatures who are as
disturbed as any I've ever heard of.

"She's drawn a picture of a place like this, I seem to recall." -2/8/74

10 August 1874

It's difficult for me to connect the massively passive Alice to the
aggressively assertive, powerful person she describes in her dreams. Her
exploits with the knife conjure images of a musketeer's swashbuckling panache;
her acts of courage those of a selfless hero. These are not "delusions of
Grandeur". This is no simple madness. But what?

"How does she really see herself then?" -24/8/74

12 August 1874

"Off with her head!"
Those were her only words today. She wouldn't explain what this meant, though
her face betrayed the violent anger that is usually associated with her tales
of the Queen of Hearts.

"What does it say about me that I've grown accustomed to such outbursts?"

13 August 1874

Everything I can think of, I have done. Treatments, remedies, disciplines and
pleasures--nothing makes a difference. Alice speaks when and about what she
wants, recites poetry on a seeming whim, draws pictures at her own pleasure.
She does nothing at my command, instruction, entreaty or request.
She's become very willful, and nothing I do or say makes a difference.
I truly do, however, become immersed in her fantastic tales of Wonderland. I
wait for the day when she claims victory over the Red Queen and her minions,
when Wonderland will be restored. Perhaps by this Alice will cure herself,
regain her balance and leave this place of her own volition.
Sometimes she appears to be so close, but at other times I'm certain it'll
never happen and she'll spend the rest of her life housed behind Rutledge's
gaunt brown walls...with me.

24 August 1874

"If it's my keen invention you'd like to destroy
I'll withstand your best shot; I've got the right toy"

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