Alex Michaelides’ The Silent Patient, published just this February, is making headlines as a New York Times #1 bestseller with a film already underway. I set out to see if it really measured up to the hype, and I ended up being pleasantly surprised. Not only are the characters complex and the pacing captivating, but Michaelides also manages to serve a twist ending that critics are raving about. Avid fans of psychological thrillers will probably see this type of ending coming, but it’s definitely an entertaining and worthwhile read regardless.
The Silent Patient follows psychotherapist Theo Faber as he begins his new position at a psychiatric facility, fueled by his desire to treat Alicia Berenson, an artist who was found guilty of murdering her husband in cold blood. The only problem is that she hasn’t spoken a word since. Theo and Alicia’s formal relationship as therapist and patient soon begins to blur as their lives become entangled; Theo begins breaking rules to meet her in secret and interview her inner circle.
One important (and unspoken) aspect of the story is the divide of gender and power: nearly all figures of authority, such as the staff at the psychiatric facility, are male, and all the notable patients mentioned are female. In a lot of ways Alicia, whom the story centres around, has been rendered completely powerless. She’s a woman who has struggled long-term with her mental health, and the men in her life have constantly used this to invalidate her experiences. They often pay little regard to her feelings and force their own onto her.
Although Theo takes on the role of Alicia’s white knight and uses his position to promote her freedom, he too doesn’t do this with the sole intent of empowering her. He’s had his own tough upbringing, and readers get the sense that his obsession with helping Alicia heal has almost everything to do with finding release from his own trauma. The more his life unravels, the more vigor he puts into “fixing” her.
In the end, Alicia is able to find her voice in a multitude of ways besides speaking. Even when she finds that Theo doesn’t have her best interests at heart, she’s able to bring those that have wronged her to justice through what little power she has.
It did sadden me that not all female characters received the same empathy and humanity though; at one point it’s mentioned that Alicia differs from the other patients, that Theo can tell that she isn’t “crazy.” The stereotype of criminally insane asylum dwellers is a harmful one that shouldn’t be promoted, and Michaelides’s treatment of the other patients no doubt lessens our ability to sympathize with them. It also hints that perhaps he isn’t as aware of the role gender plays in his plot as we might give him credit for. This was my major qualm about the entire premise since writing about mental illness and murder demands a sensitivity that Michaelides doesn’t display.
Another fascinating theme that crops up is the parallel the author draws with Alcestis, a Greek tragedy by Euripides. It depicts a husband who allows his wife to sacrifice herself to save his life, only for the gods to recognize the injustice. The wife, Alcestis, is redelivered to the world of the living and reunited with her husband, unable to speak until she has been purified. Michaelides uses this story to explore the meaning of being alive in body but dead in spirit, and what significance muteness has in dealing with trauma. The parallels to Alcestis apply to more than one character too, not just the most obvious one, which I appreciate.
If you’re looking for a psychological thriller that’ll keep you on the edge of your seat, look no further than The Silent Patient. While it might not treat its sensitive material with all the care it should, it does have quality writing and a slow-burning plot leading to an explosive ending that won’t be forgotten easily.
Chandy is a biology major/chemistry minor who's been a staff writer, Arts editor, and Managing Editor at The Cascade. She began writing in elementary school when she produced Tamagotchi fanfiction to show her peers at school -- she now lives in fear that this may have been her creative peak.