American Horror Story Wiki
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Karen is a mysterious local whose favorite pastimes include running, screaming and bleeding from her face[1]. She is a character in Double Feature portrayed by Sarah Paulson. Her behavior earned her the moniker "Tuberculosis Karen" amongst the residents of Provincetown.


Personality and Appearance

Karen has short faded light pink hair and sports a dark grey beanie along with a very thick grey jacket, a grey below-the-knee skirt, and worn out light grey gloves. She has rotting teeth, pale lips, and thin, drawn-in brown eyebrows. In some scenes, she is seen carrying a white tote bag over her shoulder.

To many in Provincetown, Karen is just the local madwoman - diseased, mentally unstable, but harmless; only to be laughed at. Karen is treated with disgust or indifference, feelings too often directed at the homeless. Despite Karen's explosive personality and equally explosive use of language, she possesses a very strong sense of morality. In many ways, Karen is a victim. A victim of her own inner conflicts. A victim of the people of Provincetown, and more specifically a victim of Belle Noir. Noir has a hold over Karen, due to her wealth and power. She forces Karen to carry out her 'dirty work', which includes stealing babies, in exchange for protection and illegal drugs. Behind Karen's unstable and angry demeanour, is an immense sadness and frustration. Karen is also a very talented painter - a point unknown by those around her, except for Mickey.



  • To Harry: "Get the fuck outta here, fucker! Out of this town. They're gonna munch on your balls!"
  • To Belle Noir: "I don't do this to be close to you. I do it because you promise to protect me from the others."
  • To Harry: "Bet your softy dick feels nice and hard now, getting some of that sweet blood flow."
  • To Harry: "Were you thirsty? You never knew thirsty before now. You fuckface!"
  • To Mickey: "I eat out of dumpsters. I haven't been touched by a man in fifteen years. So, shitting in your bucket is a fucking upgrade for me."


  • She is the twelfth character portrayed by Sarah Paulson. For a complete list of her characters, see Cast.
  • TB Karen stands for "tuberculosis", and it's the second time a character played by Sarah Paulson is listed with a moniker in the casting call. The first was "Hypodermic Sally" in Hotel.
  • Karen is one of many harbingers of danger in the series.
  • Karen and Mickey's friendship is a foil to Belle and Austin's.