You access Dorothy Crane's asylum during "Blackmail in Whitechapel" mission. However, before you speak with the woman, you will have to perform a surgery on a patient.
How to perform the surgery in Dorothy Crane's asylum?
The surgery requires you to make a few choices. You can perform a tracheostomy, tell Dorothy that you want to do it yourself or perform cardiac massage. We have tried every option and sadly - each combination of the available choices leads to the patient's death. This is simply a sequence that is supposed to build up tension and show Dorothy's determination to save every life.
This means that you are free to make mistakes, wonder about choices or simply press any button. This has no impact on the dialogs with Dorothy Crane nor it changes the game's ending. You always get a blood vial which must be analyzed in your office.