He probably hears the sound of Alfred's neck breaking in his nightmares. As heartbreaking as that was, Joker had a different thought. He looked at that moment as a wasted death. Trauma is a weapon.
While it turns out later that Alfred used this as a ruse to invite the Joker to try and eke out revenge on the villain, it does also serve as a justification for why the Clown Prince of Crime ends ...
Regardless of the choices made, the story concludes with Alfred telling Bruce Wayne he's become disillusioned by Batman's ...