OK, in as few words as possible some parts of the plot puzzle. This will be far from the finished script as motives, relationships and dramatic turning points have to meld into a workable structure. So take this as a bunch of scenes that seem to fit at this point.

Don't keep the ghouls in the audience waiting, straight to the blood in the opening credits.

• POV nurse (may sound a little like Egor). Looks into terrified patients face. "Don't worry. The doctor is very good. He will make it all very much better for you".
  
  Nurse then tightens the leather strap restraints around the patients wrist with a sharp tug.
  
  Credits play over the shiny display of medical equipment. The nurse passes instruments to the doctor at his request and returns them dripping blood and gore back to the tray. Drilling and scraping noises should play at high decibels.
  
  
• Doctor Annetta Rosen enters through the imposing gates of the Asylum. They locked behind her. She then walks down through the otherwise pleasant gardens to be greeted as the new Doctor in charge as she enters the grand old building.
  
  
• The daylight exhibits a pleasant setting for employee and patient alike. A nurse takes Annetta on a tour of the facilities. First stop is the gallery of Head Doctors. She is told that she is to become a member of this esteemed group. The camera focuses on the last doctor...

I actually saved this post as a draft the other day. I've since realised that much of the authority and power that Freidrick requires is in his position as head of the hospital. Annetta therefore needs to have a different reason for being at the hospital, and for Freidrick to take a special interest in her. Freidrick is therefore not the last deposed doctor as I began to intimate.

One thought is that the poor patient in the credits ends up being the sister that Annetta was searching for.  I'm just worried that Annetta will not have enough emotions to go around a nemesis, a love interest and a blood relative in danger!

Suggestions appreciated.