|Publication date||October 6, 2000|
Although unofficial, three fans narrated the entire casebook and it is 30 minutes long, so the reader may want to listen to it as they read. There is a link to it below in external links.
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
13 November 1864
In the twelvemonth since the conflagration, Alice has dropped further into a grim and darkly quiet abyss. It's a wonder the Superintendent didn't bury her deep within the Bedlam catacombs. The surgeons were able to cure the flesh, but they've done nothing to treat the inflammation of her brain. It's not sure what he expects me to accomplish with her. I suppose he thinks that in my twenty-three years within these troubled walls I've mastered a curriculum not taught in Oxford classrooms.
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 dementia.
"The rabbit may prove a valuable instrument for shock therapy. 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 betrays the faintest glimmer of response. I clap a pair of blocks at her ear. Nothing. Neither her sight nor her hearing appear to be damaged; 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.
9 December 1864
In many ways it's as if she's in the grave already; her countenance so still she appears to be in training for the coffin. Indeed, if she were to die today in this old hospital, nary a person would take note other than those few who recall her name from the papers. Those few who'd mutter to themselves "ah, that's a shame – the poor girl," and then turn the page to learn more of the recent stabbings in Notting Hill.
"So quiet she appeared. Was the deep madness already coursing through her mind?" -23/10/73
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 she's stretched, 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.
14 December 1864
The physicians who treated her burns reported that she barely noticed when they debrided and dressed her wounds. Indeed, she rarely showed any agitation at all when they examined her over the months. They also report, however, that on some nights, she howled like a banshee. When the nurses responded to the screams, Alice would hush, as if magically released from her demons.
Eventually, they stopped responding to these outbursts. And, after a short while, she stopped uttering any noise whatsoever.
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
22 January 1865
The bleeding doesn't appear to be causing a significant change, except for the increased pallor of her complexion. Contrasted against her drab rags, she's turned an uncanny shade of ivory. The bloodletting will prime her constitution for my restorative potion.
18 February 1865
Three amputations in a week - that's a high number, for any hospital. I dream of wiggling stumps and splintery crutches. I mumble a prayer of thanks to Napoleon's surgeon – how terrible the screams must have been before he discovered the technique for painless amputation.
I can't seem to escape the chloroform's cloying odor.
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, grey 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
24 February 1865
In the first months of her treatment, a surgeon by the name of Grantham took particular interest in Alice's case. He viewed her early reluctance to rejoin society as quite normal considering what she'd been through. The all-consuming fire. The loss of one's entire family. The shattered and scorched body. It's quite natural for anyone, let alone a child, to give way under such strain.
Yet, as the months passed, and as Grantham became more familiar with Alice, he began to comprehend that her problems were a manifestation of a far graver trauma. Bones eventually mended, as did the seared flesh; yet Alice remained locked away in her cocoon.
Unfortunate chap, this Grantham. Seems like he had a collapse of his own. One day he was going about his hospital routine, perambulating amongst the feeble and infirm. The next day, though no one knows why, he turned up every bit as diseased as one of his patients, speaking gibberish and smashing apothecary jars. I've seen it happen here where doctors pass over to the other side, and, frankly, I'm surprised it doesn't happen more often. At any rate, Grantham's tale concludes with a particularly grisly accident with a surgical implement.
23 March 1865
Nothing seems to aggravate the girl. I've tried restraint – handcuffs, leg-locks and straightjackets. 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 us with a picture, a drawing of some sort of cat. Really, it's nothing like any cat I've ever seen.
"Even a drawing so bizarre couldn't foreshadow the imaginings to come." -29/3/74
9 September 1873
I admit to a certain amount of excitement over Alice's semi-awakening. I have to be careful, though. At this point, it's difficult to tell what this development – what I'm pleased to call her "progress" – signifies.
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 seeped 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 compare her response – and my reaction to it – to the person who daily tosses a pebble into a pool of still water. Day after day, the pebble plunges to the murky bottom, causing a few nearly imperceptible ripples. One day, however, the pebble miraculously strikes a fish. What are the odds other than incredible to ponder? And what are the effects – compared to the ripples. Nurse D-, to follow the analogy, struck a fish in the pond today.
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.
12 September 1873
Two demented youths hung themselves side by side in the ward last night. As a result, I couldn't devote any time to Alice or any other patients. There was some dissension from the townsfolk about not wanting these suicides to be buried within city limits. After some discussion, they relented. It was agreed to bury the boys separately in a clandestine fashion. One will be buried far behind Ramsbottom church, the other in Ribchester.
15 September 1873
It takes two to feed her, one to wedge open her mouth and the other to funnel food and medicine down her throat. Her jaw, it seems, is clenched in a death's grip.
1 October 1873
For the past fortnight, I have labored until dawn in the laboratory preparing a new potion. Her recent activity has reinvigorated my research. I discovered last night, quite by accident really, that the smallest infusion of prussic acid and strychnine brings about a curious reaction. At least it seems to work well on the rats.
Too much of either ingredient could prove quite lethal of course.
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 remarkable... at 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
28 October 1873
I wedged a spoon into her clenched teeth while Nurse D-, serving as my reluctant assistant, poured the newest potion down her throat. When the convulsions commenced, I double-checked the harness, turned down the flame, and left the room. It's a matter of waiting now.
She'll have a fitful sleep tonight.
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 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 surgical drilling, he stopped having such delusions and was removed to the dormitory.
Alice remains quiet.
17 November 1873
She didn't stir for two weeks after the last treatment. Day after day, the orderlies force the medicine-laced broth and other necessary gruel into her. Perhaps, again, I was mistaken; perhaps nothing can save the girl.
She signaled a return to semi-consciousness with yet another sketch.
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 patient... no 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
There'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
11 December 1873
Six insane children escaped today – no word has come yet regarding their apprehension. I hope they don't harm the townspeople.
12 December 1873
Nurse D- lifted Alice into a wheelchair and rolled her, along with the one-eyed rabbit, into the airing courtyard. Perhaps a change of scenery might entice a bit of cooperative behavior. The nurse favors the latest doctrine espoused by the Commissioners. Compassion is creed of the day.
I watched from the window of my study. Alice didn't twitch.
13 December 1873
Something in the outdoor air may have stirred her 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.
16 December 1873
The missing children were found in the abandoned schoolhouse near Milton Cross. Five were returned to infirmary bruised and bloodied from their excursion to the world outside. One was found at the bottom of an abandoned well.
18 December 1873
She raves on, worse today than ever before, as her latest drawings all too clearly indicate.
21 December 1873
When I entered her room today, Alice screamed at me to leave. I called for Nurse D-. We strapped her down and increased the morning dosage.
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
4 April 1874
Months pass and again nothing.
I've increased the prussic acid by two drops per day. I wonder if I'm wasting my efforts. Perhaps another patient would be a better choice for this treatment.
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 stitched 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 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 Bosch painting.
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 chronicle decidedly more compelling than anything in Froissart.
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." -20/7/74
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.
From day to day, her moods run the gamut from despondent gloom to vicious anger. The ancients believe that a strong wind blows through the minds of the chronically unstable. If a student of Hippocrates examined Alice, he might diagnose there was a tempest with the force of a thousand mistrals raging through her head.
"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 reach."
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.
28 July 1874
She spoke at length of a place called the Fungiferous Forest. It's a place filled with mushrooms the size of 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?" -11/9/74
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.
- Thirty-minute narration done by three fans