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It is where Alice Liddell was taken to after entering her catatonic state caused by the death of her family. After her psychotic break as a child, Alice was at the mercy of the 19th century Victorian medical community. During the course of her treatment, she was mistreated and abused by doctors and the Superintendent's nephews. Alice was under the care of Dr. Heironymous Q. Wilson, who genuinely cared about her recovery which seemed hopeless at times.
Since Alice was hospitalized at Rutledge in the 1860s to the 1870s, the residing doctors and nurses were known to use various types of medicinal treatments on their patients such as the use of straitjackets, sensory deprivation, experimental medication, leeches, electroshock therapy, trepanning, and lobotomies.
American McGee's Alice and the Storybook
Alice was admitted to Rutledge on November 4, 1864, after staying a year in Littlemore Infirmary to have her burns treated, which were caused by the fire that burnt down her home and killed her family. The loss of her family had caused severe mental trauma which placed her into Rutledge when her behavior became volatile, and she was deemed a danger to herself and everyone around her.
At the asylum, Alice was mostly in a catatonic, bedridden state, and was unresponsive to most treatments and actions, from noises and lights, to electroshock therapy. She had evident dementia and it is implied she had schizophrenia. Furthermore, she would also experience fits of violence, such as screaming, being extremely dissociated from reality, and attacking the nurses and orderlies, which resulted into Alice being placed in restraints. However, she did have some lucid moments, such as talking and drawing pictures, although these moments were few and far between.
In American McGee's Alice, the asylum may be somewhat symbolized and manifested in the Mirror Image level which partially resembles a funhouse. The evidence of this is the padded rooms and celled walls (some contain "insane" children inside), Alice begins the level "restrained" on some sort of table, and this is where the Tweedles are encountered.
After a decade, Alice was released from Rutledge, supposedly making a recovery from her insanity. In actuality, Alice restored peace to Wonderland. However, she still suffered from bouts of madness caused by the memories of her family's deaths. Pris Witless got her a job at Dr. Angus Bumby's Houndsditch Home for Wayward Youth, where he continued to "treat" her by making her forget about her past through hypnosis.
Alice: Madness Returns
A year later, though Alice did not physically return to Rutledge, she suffered from a hallucination of being back in the asylum after being swallowed by the Queen of Hearts.
Wilson was seen alongside Nurse Cratchet during a horrific hallucination of Alice returning to Rutledge mentally broken. He stated his uncertainty that Alice will ever be cured and said that Alice was like a "bad penny" returning to him, leaving his reputation in ruin. He then ordered Alice to stay in her cell as if she was a dog and left with Nurse Cratchet. Despite this, the door was left unlocked for Alice to escape.
She staggered around the corridors in a straitjacket and remembered various treatments the asylum performed on patients, including on her. She saw the orderlies, Tweedledum and Tweedledee and Cratchet perform trepanning and bloodletting on her.
In the waiting room, Alice saw visions of people she knew talking about her return to Rutledge due to her recurrent unstable behavior. These included Angus Bumby, Pris Witless, Nan Sharpe and Wilton J. Radcliffe. Afterwards, Alice arrived in Hyde Park, illustrating that it was just a simple hallucination.
The asylum is described as a miserable place by Alice, it is a brick structure in both walls and roofs and is surrounded by a tall iron fence. The fence has small spikes aligning its top, possibly to discourage escapees from climbing. There is a brick path leading to the main building, where the other buildings are connected to each side. The front yard is unkempt as the grass are left untrimmed and the trees lack life.
The Waiting Room has couches and a main desk for people who are visiting a patient in the asylum.
Ward One is a huge room full of several beds intended for bunking a handful of patients. There are small desks with basins beside the beds.
The Bloodletting Room has one bed intended for the patient undergoing the therapy. There are several shelves filled with jars of leeches and a small desk beside the bed where a jar full of leeches is usually placed. There is also an anatomical skeleton by one of the shelves.
The Trepanning Room has a chair for the patient receiving the therapy. A metal headpiece with a drill is placed on their heads and the staff turns the handle to slowly drill into the patient's head. There is a small desk and a shelf near the chair where the other instruments are usually placed, as well as several trolleys for basins and towels. After Alice's hallucination, the room's roof and wall becomes punctured by giant screws, and the room is much bloodier.
The rooms for patients wearing straitjacket are padded and have barred windows. The doors are made of thick metal with a small barred window and often locked to prevent the patient inside from escaping. The other rooms in the asylum are similar to hospitals where the walls and floors are not padded and complete with a bed, a small desk, and a window. However, the windows are barred and some beds have belt straps to prevent the patient from escaping.
Electroshock therapy room
The room where electroshock therapy was given to Alice has a chair that has a machine with gauges on the side, wrist and lower body belt straps, and a metal headpiece with various wiring attached to it to deliver electric current on the patient's head. There is a machine with a lever where several levels of electricity to be used on the patient are indicated below it.
- Alice Liddell (former patient)
- Dr. Heironymous Q. Wilson
- Nurse Cratchet
- Nurse D-
- Pris Witless
- The name Rutledge is a surname and place name, and means "red pool" (from the old Anglican words "redd," meaning red, and "loec" - later "lache" - meaning a stream, or a pool in boggy land.) While seeming disconnected to a place of insanity, some of the treatments performed here - such as bloodletting, and trepanning - would have resulted in people losing a lot of blood. The blood could easily be seen as "pools of red," meaning that Rutledge is a place where blood flows.
- The motif of the Asylum in Madness Returns was inspired by the art and photography of Gottfried Helnwein.
- In Madness Returns, tilting the camera up in the Bloodletting Room will reveal an extremely disturbing sight of hundreds of leeches squirming on a bloody ceiling. Some will fall off as if it rains. This shows the horror and mental trauma Alice dealt with, as well as the lack of medical science at the time (the thought of putting leeches on people to cure mental illness may sound ridiculous now, but people back then didn't know any better at the time and lacked a deep understanding of mental health). Since Alice was a child in the asylum, she likely had a fear of leeches.
- In Madness Returns, it is unclear how much of this hallucination is based on reality: although Alice did experience many forms of treatment at Rutledge. There are signs of blood on the walls and people floating, which probably hadn't really happened as well. It is possible that Alice remembers Rutledge, or a least some of it, worse than it actually was. Another interpretation is that this hallucination is not a memory of Alice's actual past experience in Rutledge but rather her fears of what would happen to her and what treatments she would endure if she was forced to return.
- Unused text in Madness Returns suggests that if Alice were to die in the game, an obituary would be shown for her. One in Chapter Five includes dying during an "experimental lobotomy". This implies Alice could have died in the asylum level, or that there was a chance that her hallucination wasn't actually a hallucination.
- American McGee proposed Alice: Asylum, a game about young Alice's time in Rutledge.