In this passage, the Woman in White is revealed to be a city. Since the Woman has previously stated that entities from her reality don’t build cities but created her to understand humanity, the reader can infer that these extradimensional entities built the city whose avatar the Woman in White is specifically to bring it to life so that it could combat human cities. This explains the Woman’s sadness that the entities from her reality find cities “monstrous”—her creators find
her monstrous. It may also explain why they torture her; though they created her, they don’t respect the kind of life that she is. “R’lyeh” is the name of a lost city, occupied by an alien entity called Cthulhu, from H.P. Lovecraft’s 1928 short story “The Call of Cthulhu.” The allusion suggests that the extradimensional entities trying to destroy New York and humanity are the same entities Lovecraft mentions in his fiction.