Whoa, the difference between this and the old issues of Detective that I've been reading is enormous! Even the harsher comics, like A Death in the Family (Batman #426-#429) don't have the same degree of gore and in-your-face-violence (well, the Joker killing Robin is pretty in-your-face, but it's an exception).
So, what do we get out of this? Gotham's in bad shape, the mayor is out for Batman's blood, for political reasons, and Joker is being especially violent. By the end of it, it looks like Joker's having his face changed, probably. I don't know the Dollmaker, so I'm not sure what his specialty is. It's looking to be bad times for Batman, I think.