The Silent Patient
Alex Michaelides
Contributed by Carey Speaks
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Part 4

By receiving Alicia’s diary, Theo sees this as a form of communication from Alicia indicating that she has developed trust in him. After reading the journal, Theo develops numerous questions on the identity of the man who pried on Alicia, and whether the doctor mentioned in the diary was his colleague, Christian West. He subsequently confronts Christian, whose reaction proves that he had treated Alicia years before she was a patient at the Grove, and admits to this allegation. He had treated Alicia after the death of her father as a favor to Gabriel, as both of them were close friends who had schooled together. During the confrontation, Theo also realizes that Christian had been seeing other patients unofficially so that he didn’t have to declare the income from them. Theo tells Christian that he will keep this information secret as long as Christian reveals about his therapy sessions with Alicia.

Furthermore, Christian accepts that he had seen Alicia three weeks before the murder of Gabriel. He describes Alicia as moody and psychotic. In addition, he thinks that Alicia’s allegation of being watched was simply a psychotic episode, “Pure fantasy. I should have thought that was obvious” (Michaelides, 195). A similar episode took place prior while Alicia and her husband lived in Hampstead. Alicia had accused a man, who turned out to be blind, for watching their house. When asked about her suicide attempt, Christian states that Alicia only wanted to get her husband’s attention. Finally, Christian warns Theo to stay away from her since he was wasting his time with a borderline patient.

When Theo leaves Christian’s office, he meets with Yuri and talks to him about his intentions of secretly having a therapy session with Alicia. Yuri is helpful and arranges a meeting in the art room. When Alicia is brought, Theo tells Alicia that he expected her to be open and talk to him. He believes that by being issued with the diary, Alicia had communicated her intentions of talking to him. However, Alicia remains unreachable and silent throughout the session.

The author also describes the satirical relationship between Kathy and Theo. Kathy lies to Theo about going out for a walk despite the fact that she is going to engage in infidelity. Moreover, Theo is deceptive to his wife, behaving as if he does not know her true intentions, and ends up stalking his wife to the park. He sees Kathy kissing a man and follows them into the woods. Theo confirms that the man and Kathy are being intimate. Sadly, instead of confronting them, he blames himself. He views the man who was having an affair with his wife as an agent who has been sent by the deity to punish him for his mistakes. Nonetheless, Theo is angry at the man for corrupting his marriage and contemplates killing him, just as the two leave the woods. He is ultimately left in a hysterical state.

Theo decides to provoke all the characters that Alicia had mentioned in her diary so that he would find out the identity of the prying man. He starts with her art agent, and visits the art gallery to continue his investigations. While he waits for Jean-Felix, Theo notices that the “Alcestis” painting has a silhouette painted in the background to represent the man who had been prying on Alicia. When Jean-Felix arrives, Theo confronts him by telling him that he had found out that Alicia wanted to stop working with him. He also reveals that Alicia’s diary outlined how she no longer felt comfortable having Jean-Felix as her art agent, which leaves Jean-Felix in utter surprise. After leaving the gallery, Theo makes arrangements to meet up with Paul in Cambridge. In addition, Theo contacts Max Berenson while traveling to Cambridge, and informs him that Alicia had written about him in her diary. Max fears that Alicia might have mentioned his sexual assault in the journal, so he quickly hangs up the phone. Although Theo seems to have the upper hand, he admits being afraid of Max, and decides that he should not underestimate him.    

When Theo gets to Cambridge, he asks Paul to explain why he had gone to see Alicia a few months before the death of Gabriel as outlined by her diary. He is deceptive and states that although he had gone to ask for money to pay his gambling debts, Alicia had failed to lend him any money. When asked whether he knew of the prying man, Paul suggests that Alicia could have been faking his existence, “She wasn’t right in the head” (Michaelides, 210). In emphasizing this point, Paul takes Theo to the roof of the building, being where Alicia had experienced a traumatic childhood event that would take a toll on her future mental health.

Paul describes how Alicia’s father, Vernon, had killed her spirit. Vernon wished that Alicia had died in the car crash instead of Eva. Through this analogy, Theo understands why the myth of “Alcestis” had been so significant to Alicia and states, “I understood now why Alcestis had struck a chord with Alicia. Just as Admetus had physically condemned Alcestis to die, so had Vernon Rose psychically condemned his daughter to death” (Michaelides, 214). He describes how childhood emotional wounds manifest themselves in adults — and having learned about Alicia’s, Theo understands why she killed Gabriel and how he would go about helping her.

Upon his return to London, Theo informs Alicia that they are both alike. Just like her, Theo had a horrible childhood experience. They had both suffered at the hands of their ruthless fathers and escaped their childhood homes as soon as they could. Similarly, they both suffered psychologically due to their complicated childhoods. During this encounter, Theo warns Alicia that this was the last chance he had of making any progress with her, urging her to communicate. At this point, Alicia — to Theo’s surprise — speaks for the first time. Elated by her breakthrough, Theo informs Diomedes of her progress and receives the professor’s green light to continue with Alicia’s therapy. During the subsequent sessions, Alicia talks non-stop. When Theo enquires why she chose to remain silent, Alicia states that, at first, it was due to shock. But she remained silent after the trial because it was pointless for her to speak.

Alicia credits her breakthrough to Theo, who had believed the story in her journal. She also acknowledges that an altercation took place between her and Jean-Felix on the night that Gabriel died. During this session, Theo reveals as much about his childhood as Alicia. At the same time, he fears that he had crossed a line with her, “We were crashing through every last boundary between therapist and patient” (Michaelides,  222). Alicia also narrates about the day that Gabriel died.

She was painting in her studio when she noticed a masked man standing behind her. He attacks her and drags her from the studio to the kitchen. Although Alicia expected to use Gabriel’s gun to kill the intruder, he had anticipated her move and removed the weapon from the cabinet, where Alicia had hidden it. From her depiction of these events, Theo realizes that she was spiteful, and wishes that the intruder had killed her. The masked man was sadistic and had toyed with her while she was tied up to a chair. He waited for Gabriel’s arrival and bashed his head with the butt of the gun before shooting Gabriel six times.

Conversely, Theo finds her story to have inconsistencies with the police report. For instance, Alicia was not found tied up by the police as she had claimed. Moreover, Gabriel had only been shot five times. Theo gets annoyed because he feels that Alicia is lying to him. When Alicia leaves his office, Theo transcribes their conversation and reports to Professor Diomedes’s office to inform him about her revelation. In the professor’s view, Alicia has completely lied about her story. He even doubts whether the prying man that she describes was real, and describing her narration as a performance to convince Theo to believe her, “Alicia has cast herself as the victim and this mystery man as the villain. Whereas in fact Alicia and the man are one and the same. She killed Gabriel” (Michaelides, 236). Finally, Professor Diomedes advises Theo to confront Alicia during the next therapy session so that she would reveal the truth.

This, however, does not get to happen, as Theo finds Alicia admitted to the ward. His colleagues claim that she had attempted to commit suicide by overdosing on pills. Theo sees this as his failure and, again, he blames himself. However, when everyone clears from the ward, Theo realizes that Alicia had a stab wound on her arm suggesting that somebody had injected her with a lethal dose of morphine. Since Theo suspects Christian, he informs Professor Diomedes and Stephanie about his involvement with Alicia long before she was a patient of the Grove. Theo suggests that Christian had tried to murder Alicia to conceal this information, since she could not talk. Professor Diomedes calls the police who apprehend Christian and record statements from the employees of the hospital.

This section of the book also describes the marriage of Theo and Kathy, which is in shambles. After following the man who was having an affair with his wife, Theo finds out where he lives. In addition, he finds out that Kathy’s lover was married, and subsequently states that both he and the man’s wife were victims of the betrayal of their spouses. Over a periodic stretch, Theo keeps watching and returning to the stranger’s house, at where he eventually plans on revealing to the man’s wife of how both their spouses were having an affair. After purchasing a black mask and a pair of gloves, he creeps into the woman’s house and finds her painting. This part of the novel ends with Theo describing this scene as the first instance that he met Alicia Berenson.

Theo was the man in the mask.


The fourth section of the book highlights the conflict in the narration and defines how it is resolved to form the anti-climax portion of the book — which is introduced by Alicia’s journal. Through Theo’s investigative actions, the characters mentioned the diary (Jean-Felix, Paul and Max) are portrayed as the main suspects who were involved in Gabriel’s murder. This conflict is built up by Alicia’s description of that fateful night, and gets resolved when the author indicates that the man in the mask was Theo. This creates a mystical effect that makes the book a thrilling experience. By withholding this information until the final chapter of the section, the author creates further suspense in the audience. It was sardonic that Alicia’s helper, Theo, was involved in Gabriel’s murder, and represents Theo’s character as hypocritical.

The author’s description of how Theo catches his wife in the act of cheating on him portrays to the audience how Theo had unresolved childhood emotions. The voice of his father urges him to kill the man having an affair with his wife, which subsequently invokes a murderous instinct in him. Theo nearly comes to act on this instinct: he attacks Alicia, the wife of Kathy’s lover. Moreover, Theo’s constant need for love is emphasized by his self-loathing, which is demonstrated by his failure to confront his wife and blaming himself for her promiscuous behavior. His guilt and anger built up to a murderous rage that becomes consequential to Alicia. By confronting Gabriel because of his affair with Kathy, Theo causes Alicia to kill her husband.

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