In her expose on Briarcliff Manor, Lana (Sarah Paulson) says almost the exact words as Geraldo Rivera did in his 1972 documentary on Willowbrook State School: "These images and sounds are far more powerful than any words that can be spoken. But how can I describe to you the way it smells? It reeks of filth, of disease. It smells of death." (Originally: "This is what is looked like, this is what it sounded like but how can I tell you about the way it smelled? It smelled of filth, it smelled of disease, and it smelled of death.")
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Sarah Paulson plays an elderly woman in this last episode, created with make up, and her son Johnny, played by Dylan McDermott, also appears in the episode. In real life, McDermott is 14 years older than Paulson.
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Sarah Paulson's reporter walk-through scene in Asylum was pulled directly from actual footage of Bill Baldini's exposé piece on Pennhurst Asylum in Spring City, PA. Baldini's work led to the closure of Pennhurst and the release of all its patients. Pennhurst is now the location of a seasonal haunted house and has been featured on numerous shows, due to the reported extreme paranormal activity in Pennhurst's buildings.
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