Ovidio G. Assonitis’ 1981 horror flick Madhouse (aka And When She Was Bad and There Was a Little Girl and not to be confused with 1974’s Madhouse) is a good-looking but ultimately disappointing genre flick that throws a few interesting ideas around but doesn’t quite know how to fit them all together. But man, does it make a killer opening impression as well as pack in a few unsettling kills. That said, it’s easy to see why the film has its following despite some oddball flaws that keep it from being truly great.

That haunting opening still packs a wallop, though. As a creepy lullaby plays, one young twin gently rocks another in a darkened room before suddenly stopping to smash her in the face with a rock or brick of some sort. It’s definitely jarring, but actually has nothing to do with the film unless it’s meant to set the overall mood.

Yes, we find out that one sister had indeed been incessantly mean to the other throughout their childhood. But it’s Julia (Trish Everly), now a teacher for deaf children who was the victim of her sister Mary’s (Allison Biggers) cruelty. Julia’s got flawless skin and not a scratch on her face or body, but she’s bearing plenty of fears thanks to her sister making her early years a living hell. Given that there’s no mention of her receiving any sort of plastic surgery (she also mentions Mary’s dog used to bite her frequently), that opening seems open to interpretation.

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