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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.


Karen is first seen in the supermarket, yelling at Harry to leave the town before they munch on his balls. Harry dismisses her warning as a sign of madness. Karen is later at the The Muse, sneaking in to take food from the plates of tables; which results in her being kicked out of the restaurant. She notices Harry again and warns him to leave the town and don’t take the black pill. Later, Karen arrives at Belle’s house, delivering to her house a baby for Belle to consume, much to Karen’s sorrow and reluctance. However, Belle gives her drugs and warns her to stay in line.

When Harry takes the pill and becomes thirsty for blood, Karen notices his change of behaviour and angrily insults him for not heeding her warning. Mickey takes Karen in during the cold winter, and keeps her warm with a bed and some drugs. Mickey suggests to Karen that she tries some Muse and gives her a black pill. A scared Karen smacks the pill away, telling Mickey she will never take it, despite having a talent in art that the pill could enhance, as she’s scared that she will end up like one of the pale creatures.

Karen later meets up with Mickey, who is driving a drag racing car, and is becoming successful as a script writer due to taking the pill. While riding in the car, Karen is disgusted at how the pill has changed Mickey and demands to leave. While drawing on the beach, Belle arrives and demands she steal baby Eli from the Gardner residence, threatening to feed to her to the pale creatures if she does not comply. She later reconciles with Mickey, who she asks for help to break into the Gardner residence to abduct Eli. Much to her horror, she finds Doris, who is mutating slowly into a pale creature. Karen flees the house in fright, but is cornered by a group of pale creatures outside. Mickey holds them off, and advises her to take a pill so the creatures can ignore her. Karen still refuses, to which an annoyed Mickey then abandons her to the creatures. A scared Karen desperately takes a pill, which wards off the creatures.

The next day, Karen discovers that her talent for art has been greatly enhanced, and is relieved that she won’t become a pale creature. However, when she begins to develop the side effect of craving blood, Mickey tries to convince her to kill someone on the beach so she can feed, but Karen refuses as she does not want to kill an innocent person. Mickey drags her to the beach, and upon spotting a bystander on the beach, urges her to kill him. Desperate not to harm an innocent person, Karen feigns interest and hugs Mickey for helping her, but she then proceeds to kill Mickey by ripping his throat out with her bare teeth and feeding on him. Depressed over what she has done, Karen then commits suicide by slitting her wrists and then walking into the ocean, leaving behind her a red tide.


  • 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, angry at him for taking the pill: "Ha ha, you took it! Bet your softy dick feels nice and hard now, getting some of that sweet blood flow. Why did you do that?! You shouldn't have done that, mοthеrfսckеr! What, 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.