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Lady Madeline is Roderick Usher's twin sister. She is sick with a disease called catalepsy. One with this disease is in a trance-like state with loss of voluntary motion and failure to react to stimuli. The narrator of the short story and Roderick assume that Madeline is dead (since she has a cataleptic shock) and proceed to entomb her for two weeks. Poe wants us to wonder if Madeline is really alive or dead.