The silent patient by alex michaelides

In other words, I had set into motion a plan to help Alicia without actually knowing how to execute it. Now I had to deliver, not just to prove myself to Diomedes, but, far more important, to do my duty to Alicia: to help her. 

Looking at her sitting opposite me, in a medicated haze, drool collecting around her mouth, fingers fluttering like dirty moths, I experienced a sudden and unexpected wrench of sadness. I felt desperately sorry for her, and those like her—for all of us, all the wounded and the lost. 

Of course, I said none of this to her. Instead I did what Ruth would have done. 

And we simply sat in silence.


I OPENED ALICIA’S FILE ON MY DESK. Diomedes had volunteered it: “You must read my notes. They will help you.” 

I had no desire to wade through his notes; I already knew what Diomedes thought; I needed to find out what I thought. But nonetheless I accepted it politely. 

“Thank you. That will be such a help.” 

My office was small and sparsely furnished, tucked away at the back of the building, by the fire escape. I looked out the window. A little black bird was pecking at a patch of frozen grass on the ground outside, dispiritedly and without much hope. 

I shivered. The room was freezing. The small radiator under the window was broken—Yuri said he’d try to get it fixed, but that my best bet was to talk to Stephanie or, failing that, bring it up in Community. I felt a sudden pang of empathy with Elif and her battle to get the broken pool cue replaced. 

I looked through Alicia’s file without much expectation. The majority of the information I needed was in the online database. Diomedes, however, like a lot of older staff members, preferred to write his reports by hand and (ignoring Stephanie’s nagging requests to the contrary) continued to do so—hence the dog-eared file in front of me. 

I flicked through Diomedes’s notes, ignoring his somewhat old-fashioned psychoanalytic interpretations, and focused on the nurses’ handover reports of Alicia’s day-to-day behavior. I read through those reports carefully. I wanted facts, figures, details—I needed to know exactly what I was getting into, what I’d have to deal with, and if any surprises were in store. 

The file revealed little. When she was first admitted, Alicia slashed her wrists twice and self-harmed with whatever she

could get her hands on. She was kept on two-on-one observation for the first six months—meaning two nurses watched over her at all times—which was eventually relaxed to one-on-one. Alicia made no effort to interact with patients or staff, remaining withdrawn and isolated and for the most part, the other patients had left her alone. If people don’t reply when you speak to them and never initiate conversation, you soon forget they’re there. Alicia had quickly melted into the background, becoming invisible. 

Only one incident stood out. It took place in the canteen, a few weeks after Alicia’s admission. Elif accused Alicia of taking her seat. What exactly had happened was unclear, but the confrontation escalated rapidly. Apparently Alicia became violent—she smashed a plate and tried to slash Elif’s throat with the jagged edge. Alicia had to be restrained, sedated, and placed in isolation. 

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