Review | The Silent Patient

Title: The Silent Patient by Alex Michaelides

Date Published: May 1, 2019

Dates Read: April 19-21, 2021

Current Goodreads Rating: 4.11/5

I have been hopping around genres like crazy this year and this book is no different. While both The Silent Patient and The Secret Keeper are both mysteries, this book has a little bit more of a horror feel to it - though perhaps that's because the entire plot takes place in an insane asylum.

This was Goodread's Best Mystery & Thriller from 2019 (which, side note that no one but me probably cares about - I've now read a substantial amount of the 2019 winners entirely by accident) and I think it earned its title. However, I did have the nagging feeling that I'd read this story before.

Ok, so what happens? Alicia Berenson has the perfect life. She's an accomplished painter, married to a loving photographer named Gabriel who understands her passions, and a beautiful house in the heart of London. However, despite her idyllic life, police are called to her house one night in response to the sound of gunshots. What they find is a silent and bloodied Alicia and a murdered Gabriel, tied to a chair and shot five times.

Tried in the court of public opinion and in an actual judicial court, Alicia is found guilty pretty much immediately. Due to the fact that she refuses to speak on her innocence or her guilt, she is sentenced to an insane asylum indefinitely. Criminal psychotherapist, Theo Faber is obsessed with Alicia's case. Why doesn't she talk? What could he learn from her? As he learns more about why she shot her husband he is forced to look into his own motivations and come to terms with his demons.

Ok, so what did I think? I really enjoyed this book for probably about the first 2/3 - 3/4s of the story. The asylum setting truly was creepy enough to seep into my real life (let me tell you, reading about a brutal murder while you're the only one awake in your apartment is just asking for nightmares, but I do it because I'm a masochist) and the story behind Alicia's break down was intriguing. Even if their supposedly perfect marriage wasn't as perfect behind closed doors, what would a man have to do for his wife to snap and load five rounds of bullets into his body?

This story is told in what I'd describe as fragmented pieces. A majority of it is told from Theo's point of view - being hired at Alicia's facility, leading Alicia through experimental therapy treatments to try to get her to talk, and working with the other therapists within the facility to learn more about her - but each new section begins with a few entries from Alicia's diary from before she fell silent.

These sections of Alicia's diary was occasionally hard to read for me because of how easily her husband dismissed her concerns. She believes that someone is following her and watching her from the house, but Gabriel is quick to dismiss her concerns. He treats her as though she is losing her mind and, as the readers, we don't know whether to believe him or to fear for Alicia's safety. Could she be imagining the shadowy figure watching her from across the street? Or is she just another victim of a male not believing her story?

It is clear that Alicia suffers from some kind of mental disorder as she separates herself from all who would consider themselves her friends. She writes in her diary about how her neighbor is awful and that her art dealer is only her friend because her art brings him so much money. But I couldn't help but feel like I was reading a modernized version of Rosemary's Baby. Alicia is so alone and no one is really there to look out for her or her mental health.

Theo's obsession with learning the motive behind Alicia's silence felt suspect from the beginning of the novel, but perhaps that's just because I'm biased and feel like Alicia should be left alone if she wants to be. Who knows? Maybe Gabriel was a shitty dude and deserved what he got? I'm kidding - maybe - but whenever Theo isn't obsessively thinking about Alicia he's worrying about if his wife is cheating on him. It's like, come one dude, have your own life. Theo's character felt incredibly similar to another psychotherapist in a book I read back in 2019. The Devil Aspect takes place in 1935 and is also narrated by a man like Theo. Spoiler alert: he's the bad guy and I think that's ultimately why I didn't immediately trust Theo.

All in all, I thought the play between Theo and Alicia was fascinating. He's a man in power who talks too much and she's potentially a victim who doesn't talk at all. I think it would have made for a truly powerful twist if I hadn't figured out the twist about three or four chapters before the big "reveal."

You know the drill. Spoilers ahead. You may have guessed it already while reading this review, but Theo is the shadowy figure that lurks outside of Alicia's window because - surprise, surprise - his wife is having an affair with Gabriel. He ties Gabriel up and waits for Alicia to get home. He basically gives Gabriel a Sofie's Choice - should Gabriel sacrifice himself to save Alicia or should Alicia die so that Gabriel survives?

Because men ain't worth shit Gabriel picks the cowards way out and tells Theo to shoot Alicia. Which, when Theo leaves the gun in Alicia's hands, she takes no time to load up her husband with lead. It's a completely understandable reaction in my opinion, but it was the only part of the twist that I hadn't seen coming. It seemed incredibly clear to me that the story was told in fractured scenes. Theo never spoke or thought of Alicia when he was not in the asylum, which would be great work ethic, except that it just didn't seem like the type of therapist Theo was. I have been blown away by twist endings before, but this one was more like a gentle breeze and that was really what kept me from enjoying this book fully.

Long Story Short:

• Asylums are still creepy

• Women are usually right even if they do shoot their husbands five times

• Twist endings are either really good or really not

My Rating: 4/5