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Notes Extracted from the Casebook of Hieronymous Q. Wilson, M.D.
Rutledge Asylum

On November 5, 1863, Alice Liddell was severely burned in the fire that destroyed her family home in Oxford, and took the lives of her parents and her older sister, Lizzie. While the girl's seared skin gradually healed during a year of hospitalization, the trauma caused by her family's horrific demise deepened. The orphan's condition swung from comatose to uncontrollably hysterical and back in the course of a given hour. Leaned medical opinion deemed her a danger to herself and an indefinite term of institutional confinement was ordered.

At her preliminary examination at Rutledge on November 11, 1864, Alice, presented as deaf, dumb, and blind to stimulation. She seemed, in the brutal expression of the practice, "in training for the coffin." Only her age saved her from immediate assignment to the notorious Bedlam catacombs. Despite insensible passivity, preternatural quietness, and evident dementia, a course of treatment was prescribed.

During the first 6 months of 1865 she was subjected to all the best contemporary remedies--without result. Cold plaster sessions and blood-letting were ineffective and unproductive; applications of experimental shock apparatus useless; likewise massive doses of laudanum. In a desperate toss, restraints (including a straitjacket!), solitary confinement, sensory deprivation, confiscation of her toy rabbit and cancellation of afternoon tea were tried - and failed completely. She would not respond!

She did not resist treatment or in any way react to it. She simply ignored it. She shut down completely, and shut out the world. Shortly after the diagnosis of demented" was confirmed, she fell into a comatose state.

Despite her mental infirmity, she appeared physically fit. Staff remained hopeful (not to say optimistic) that she would regain her balance. Her bodily functions were reasonably attended to, but there were pitifully few signs of recovery. Then, in the autumn of 1873, after eight years of fitful sleep, Alice "spoke" by drawing. Her first picture was of an alarming cat!

But only bouts of angry, incomprehensible screaming, and hysterical sobbing follow this dubious opening of communication. She became intermittingly convulsive and had to be sedated frequently. From time to time, various medicinal preparations and chemical potions were forcibly administered-to little effect. And she required more than verbal encouragement to eat.

Something that did look like progress occurred in late November of that year. While her inarticulate mutterings and screams continued, she responded-- if not appropriately, at least comprehensibly--to her surroundings. When grossly insulted by ward orderlies (the Superintendent's imbecilic nephews!), Alice, without warning, scarred off one of the twins with her furious attack (she handled her spoon like a knife), and made the other bleed like a stuck pig. but then, she turned the makeshift weapon on her own wrists!

Fortunately, staff prevented her from doing terrible physical damage to herself. But she regressed to her previous state: days of silence, sometimes sketching fantastical scenes and characters, spouting senseless poetry, then incomprehensible raving, catatonic trances, and unintelligible shouts and groans. Suddenly in spring of this year, there was a change. She began to speak.

Civil then vulgar. Declarative then cryptic speech, in and out of her chaotic, violent, deranged and terrifying dream world. But the periods of lucidity grew longer. She became confidential. She shared some of her sadness, her grief over loss of family and herself. But most often she droned on and on with about fantastical visions. These delusions had no "reality," of course, but conversation makes a connection with the world. This was significant development.

Cogent but often disconnected (and to me meaningless) talk about Wonderland, tea parties, the "fungiferous forest, Boojums, Jackbombs, Snarks, Demon Dice, and the "dastardly" Red Queen was, nonetheless, encouraging. Through her moods ran the gamut from despondent gloom to vicious anger to confident calm, this was a positive prospect. But the emergence of a "normal" Alice, a "cured?" Alice was not to be. Throughout the summer and into the autumn, she seemed to vacillate between fantasy and reality.

By October, my own health failing, I recognized I had done everything I was capable of doing for her. After a decade of treatment, having addressed her psychic condition with full array of our age's therapies, she had emerged from her catatonia- but we didn't know why!

I once thought the drug regimen had been effective: now I vigorously doubt it. Reunification with her childhood toy? It turns out that rabbit was a stand-in for the original, which disappeared years ago. Something I said? She did nothing at my command, instruction, entreaty, or request. To the extent she was "cured" she, I believe, cured herself.

As she appeared more or less stable, though plagued by hallucinations that frustrated more than frightened her, I succumbed to the Superintendent's entreaties. As further "cure" seemed doubtful, further confinement was deemed a waste of everyone's time.

Lacking family and friends, but possessed of a small inheritance, she left Rutledge in November-depressed, but committed to the struggle for her sanity. Nurse Witless found her a situation with Dr. Bumby, and Alice was released to his care at the Houndsditch Home and Refuge for Wayward Youth in the East End. I wish them both well.

Trivia

  • Dr. Wilson's first name is misspelled as Hieronymous.

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