A few weeks later, the men are again playing poker, and Eunice and Stella are secretly packing up Blanche's belongings while she is bathing. It is apparent that Stanley and Stella are sending Blanche somewhere away from New Orleans, but we don't know yet where they intend for her to go. Eunice asks Stella how she had managed to tell Blanche that she was leaving, and Stella tells her that she had told Blanche that someone was coming to take her away to the countryside. Blanche had twisted Stella's words to believe that Shep Huntleigh was coming to take her away to Texas. With Eunice offering her support and encouragement, Stella seems to regret her decision but admits that she knew that she had to send Blanche away when Blanche had told her that Stanley had raped her. Stella believed that her husband would never do such a thing, and she knew at that point that she needed to get help for Blanche.
Blanche steps out of the shower and is excited about what clothes to wear because she wants to look her best when Shep arrives. She asks Stella if he has called, and Stella sadly replies that he has not. Blanche tries not to seem too hurt and begins to boast excitedly of the beautiful places that she will travel to and the grand people who she will meet. Stella doesn't tell her anything about where she is really going.
While Blanche is talking excitedly about her trip, Mitch hears her voice and is temporarily distracted from the poker game. Stanley snaps him to attention, and even though it is clear that he is still entranced by Blanche, he has given up all hope of trusting and loving her. Blanche hears Mitch's voice and seems to be agitated by it - and again, the Varsouviana is heard playing in the background. She suspects that Eunice and Stella are hiding something from her, but they calm her down by reminding her of the vacation that she is about to take.
The doorbell rings, and Eunice volunteers to get the door. Blanche becomes ecstatic and dreamy because she believes that Shep has finally come to take her and rescue her from living in such a horrible place. She gloats about living on the sea and grows more excited about the thought of going away with a new beau. But instead of Shep Huntleigh, Eunice ends up escorting a doctor and a matron (nurse) to the Kowalskis' apartment. Blanche begins to back away from him in fear because he is not who she believed that they would be, and Stella becomes hysterical because she realizes that she is actually going to send her sister to an insane asylum.
The matron tries to corner the terrified Blanche, who is unwilling to leave with them, and the Varsouviana, which sounds distorted and distant, plays while she rushes into the other room. The kindly, calm doctor speaks to her reassuringly and soothes her apprehension. Perhaps softened by the attention of a man, Blanche complies with his orders and tells him that she has "always depended on the kindness of strangers," which, of course, is completely false because she has always been hurt by strangers who have used her for their own pleasure. At the end of the play, we see Blanche being taken away from Stella and Stanley by the doctor and the matron as Stella begins to scream for her sister and berates herself for sending Blanche away.
Stanley tries to soothe Stella and takes her to the other room, calming her down with sweet words while also unbuttoning her blouse. Again, Stanley and Stella greet tragedy in their lives by turning to each other with almost savage passion. While they proceed to make love in the other room, the men continue to play poker, almost as if Blanche Dubois had never entered their lives.
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