In present day, a newlywed couple, Teresa and Leo, explore the now-abandoned Briarcliff Manor, a former insane asylum in rural Massachusetts. Flashback to 1964 shows Kit Walker being committed there, accused of being infamous serial killer "Bloody Face". Kit protests his innocence and flashes of his scattered memory suggest something far more sinister responsible. At Briarcliff, Kit befriends Grace, a fellow inmate believed to have murdered her family. Journalist Lana Winters trespasses onto Briarcliff, intent on exposing its mistreatment of inmates, so she can gain a better career for her and for her lover Wendy Peyser, a teacher. She is confronted by the tyrannical Sister Jude, who has her committed to the asylum because of her homosexuality. A bitter rivalry is ignited between Sister Jude and Dr. Arthur Arden, who uses torturous experimentation and murder in his quest to discover an ultimate immunity in the human body, so he can let humans survive even through a nuclear warfare. In present day, Teresa and Leo are attacked and pursued through Briarcliff by Bloody Face.
Leo and Teresa are two horror junkies visiting reputedly haunted sites on their honeymoon. They explore the Briarcliff Manor Sanitarium, an abandoned mental institution and once a tuberculosis hospital where many thousand died. Teresa having a fetish for the haunted, the couple begins having intercourse inside of the building. Teresa interrupts the session after hearing something move inside of the asylum, promising to make it up to Leo if they go investigate. They track down the sound to a locked door with a food hatch, through which Leo sticks his arm where it is severed by an undetermined cause.
With Leo in shock and bleeding, Teresa promises to go find help. She runs to the main door only to find it chained and padlocked from the inside. She discovers a hidden tunnel and while running through she encounters Bloody Face, wearing a mask of human skin.
Kit Walker is a gas station worker making a lean living with his wife, Alma. Unfortunately, fear of social ostracism has forced them to keep their marriage a secret, as Kit is white and Alma is black. A series of unexplained explosions, extremely bright light, loud noises and apparent anti-gravity occur during which Alma disappears and Kit is knocked out.
Lana Winters is an ambitious journalist sent by her paper to report on the commitment of the famed serial killer "Bloody Face" to the sanitarium. Sister Jude, the asylum's authoritarian and sadistic administrator, does not take a liking to Lana or her persistent questioning. Unknown to anyone, Sister Jude harbors sexual feelings for the sanitarium's founder, Monsignor Timothy Howard, an ambitious priest aiming to become Pope. When the alleged murderer steps out of the police car, it's revealed that Kit is the so-called perpetrator, accused of skinning three women – including Alma – alive and he is being held pending determination if he is sane to stand trial. He denies ever killing anyone, blaming Alma's disappearance instead on extra-terrestrials, which Sister Jude does not believe.
Kit later encounters the inmates of the institution in the common area, including a nymphomaniac named Shelley who has sex with the orderlies at night. Grace, a seemingly sane patient, warns Kit not to turn off a loud French recording of "Dominique", as the orderlies require it to be played. Spivey, a bully in the asylum, picks a fight with Kit by spouting off racist remarks about Alma. The two begin to fight and are broken up by Sister Jude blaring a screeching whistle. The guards drag Kit to solitary confinement.
Sister Jude has a conversation with Dr. Arden, the physician of the institution's medical unit. She has a strong distrust of him, mainly due to their differing ideologies based on religion and science, respectively. She wonders why all of the patients who recently disappeared had no family or friends, to which Arden contends that they all died and were cremated. Later, Dr. Arden secretly sedates Kit and vivisects him, extracting a metallic object from his neck that grows legs and flees while Kit has apparent flashbacks to alien abduction. Grace visits Kit in his cell. They get to know each other a little bit more and talk about their alleged crimes, to which they both claim innocence. Grace allegedly killed her entire family.
Sister Mary Eunice is sent by Dr. Arden with a bucket of offal to feed something in the woods. Lana encounters her there and joins her as she flees back through the secret tunnel. While sneaking around the asylum Lana is attacked by something in one of the isolation rooms, when she sticks her arm in through a feeding door as does Leo in 2012, and is knocked out. Upon waking, she is locked in a sanitarium room as its newest patient. She learns from Sister Jude that she visited Lana's partner, Wendy, and blackmailed her. Threatening to out both Wendy and Lana, thereby ruining Wendy's teaching career and having Lana committed for her homosexuality anyway, Sister Jude has Wendy sign papers committing Lana to the asylum.
BillyBilly is a recurring guest character in Asylum. He has a perhaps tenuous friendship with Kit Walker.
With a small crew in tow, Billy visits Kit Walker at his job to enlist his aid, and his boss' gun, to terrorize a black man that purportedly propositioned a friend's sister. Later, although Billy isn't shown, Kit believes that the group of men who try to set fire to his house are Billy and his friends since it was Billy's truck and he is heard laughing. The police, however, are skeptical about this.
In an alternate alien-free accounting of events by Dr. Thredson, Billy and friends follow Kit home after their visit to the garage and harass him to the point of homicidal rage.
- Teresa: "Legend has it that once you were committed at Briarcliff, you never got out."
- Shelley: "Do you think I'm full of shame and regret for what I've done now, Sister? You could shave me bald as a cue-ball and I'd still be the hottest tamale in this joint!"
- Monsignor Timothy: "The tonic for a diseased mind lies in the 3 P's: productivity, prayer, and purification."
- Sister Jude (to Kit regarding Alma): "I wonder: did her dark meat slide off the bone any easier than your other victims?"
- Grace: "What you put out into the world comes back to you."
- Sister Jude: "Mental illness is the fashionable word for sin."
- Sister Jude
Here, you will repent for your crimes to the only judge that matters: the Almighty God.
There is no God. Not one that would create the things I saw.
- Sister Jude
Your story about little green men? That won't do here.
- Kit Walker
They weren't human, they were monsters.
- Sister Jude
All monsters are human. You're a monster.
- Sister Mary Eunice (about Sister Jude's whipping cane): "It's not big enough, sister."
- Bedlam - Wendy mentions this film.
- Jennifer Jones - Sister Jude claims this movie star is a 'true lady'.
- John F Kennedy - Timothy mentions the deceased president.
- Peter Abelard - Dr. Arden mentions this French philosopher.
- Lana Turner - Sister Jude claims Lana Winters is named after this movie star.
- The song of Bernadette - Sister Jude mentions this film.
- Zachary Quinto (Oliver Thredson) is credited but does not appear.
- From Teresa's iPhone: Briarcliff was built in 1908, the largest tuberculosis ward on the East Coast. 46,000 died there. The corpses were shuttled out through the "death chute". The Catholic Church purchased and converted it into a sanitarium in 1962.
- Location hints: Lana's license plate is from Massachusetts. Her paper, "The Gazette" seems to have a local scope, as they are covering a story regarding a small bakery. She mentions Canada geese. Kit is delivered to Briarcliff by a vehicle bearing Massachusetts State Police license plates. Chicopee and Provincetown (towns in Massachusetts) are mentioned in the episode. We can probably assume Briarcliff is also in Massachusetts.
- This episode is a reverse of the series Pilot episode (the Pilot flashing back to a past event before showing the present, while this episode shows the present before flashing back to the main storyline of the second season).
- Two music cues from Pino Donaggio's score for the 1976 film version of Carrie are used in this episode. Bucket Of Blood is used three times, as Lana Winters approaches the asylum; as Lana is watching Kit Walker being delivered to the asylum; and as Sister Mary Eunice appears to be feeding someone or something in the woods. For The Last Time, We'll Pray is used as Lana makes her way inside the asylum.
- According to producer Tim Minear, the "true" story of the interracial couple Barney and Betty Hill inspired the alien abduction subplot and the characters of Kit and Alma Walker.
- What actually happened to Alma?
- What is the true identity of Bloody Face?
- What severed Leo's arm?
- What has Arden created in the woods?
- Is Sister Eunice really stupid, or just pretending?
- Is the chip in Kit's neck real or was it all just inside his head?
- ↑ credited as, but referred to as Jack
- ↑ credited as, the patient dancing in Rec Room
- ↑ 'CARRIE' CUES & ECHOES OF 'SISTERS'
AS 'AMERICAN HORROR STORY' BEGINS ITS SECOND SEASON. De Palma a la Mod (October 17, 2012).