The Silent Patient

by Alex Michaelides

  “He killed me,” she said. “Dad just killed me.”

  Now, at last, I had something to work with. Something I knew about—the emotional effects of psychological wounds on children, and how they manifest themselves later in adults. Imagine it—hearing your father, the very person you depend upon for your survival, wishing you dead. How terrifying that must be for a child, how traumatizing—how your sense of self-worth would implode, and the pain would be too great, too huge to feel, so you’d swallow it, repress it, bury it. Over time you would lose contact with the origins of your trauma, dissociate the roots of its cause, and forget. But one day, all the hurt and anger would burst forth, like fire from a dragon’s belly—and you’d pick up a gun. You’d visit that rage not upon your father, who was dead and forgotten and out of reach—but upon your husband, the man who had taken his place in your life, who loved you and shared your bed. You’d shoot him five times in the head, without possibly even knowing why.

  The train raced through the night back to London. At last, I thought—at last I knew how to reach her.

  Now we could begin.

  CHAPTER NINE

  I SAT WITH ALICIA IN SILENCE.

  I was getting better at these silences, better at enduring them, settling into them and toughing it out; it had become almost comfortable, sitting in that small room with her, keeping quiet.

  Alicia held her hands in her lap, clenching and unclenching them rhythmically, like a heartbeat. She was facing me, not looking at me, but gazing out of the window through the bars. It had stopped raining, and the clouds momentarily parted to reveal a pale blue sky; then another cloud appeared, obscuring it with gray. Then I spoke.

  “There’s something I have become aware of. Something your cousin told me.”

  I said this as gently as I could. She didn’t react, so I went on.

  “Paul said that when you were a child, you overheard your father say something devastating. After the car accident that killed your mother … you heard him say that he wished you had died, instead of her.”

  I was certain there would be a knee-jerk physical reaction, an acknowledgment of some kind. I waited, but none came.

  “I wonder how you feel about Paul telling me this—it might seem like a betrayal of confidence. But I believe he had your best interests in mind. You are, after all, in my care.”

  No response. I hesitated.

  “It might help you if I tell you something. No—perhaps that’s being disingenuous—perhaps it’s me it would help. The truth is I understand you better than you think. Without wishing to disclose too much, you and I experienced similar kinds of childhoods, with similar kinds of fathers. And we both left home as soon as we could. But we soon discovered that geographical distance counts for little in the world of the psyche. Some things are not so easily left behind. I know how damaging your childhood was. It’s important you understand how serious this is. What your father said is tantamount to psychic murder. He killed you.”

  This time she reacted.

  She looked up sharply—straight at me. Her eyes seemed to burn right through me. If looks could kill, I would have dropped dead. I met her murderous gaze without flinching.

  “Alicia. This is our last chance. I’m sitting here now without Professor Diomedes’s knowledge or permission. If I keep breaking the rules like this for your sake, I’m going to get fired. That’s why this will be the last time you see me. Do you understand?”

  I said this without any expectation or emotion, drained of hope or feeling. I was sick of bashing my head against a wall. I didn’t expect any kind of response. And then …

  I thought I imagined it at first. I thought I was hearing things. I stared at her, breathless. I felt my heart thudding in my chest. My mouth was dry when I spoke.

  “Did—did you just … say something?”

  Another silence. I must have been mistaken. I must have imagined it. But then … it happened again.

  Alicia’s lips moved slowly, painfully; her voice cracked a little as it emerged, like a creaking gate that needed oiling.

  “What…” she whispered. Then she stopped. And again: “What … what—”

  For a moment we just stared at each other. My eyes slowly filled with tears—tears of disbelief, excitement, and gratitude.

  “What do I want? I want you to keep talking.… Talk—talk to me, Alicia—”

  Alicia stared at me. She was thinking about something. She came to a decision.

  She slowly nodded. “Okay.”

  CHAPTER TEN

  “SHE SAID WHAT?”

  Professor Diomedes stared at me with a look of stunned amazement. We were outside, smoking. I could tell he was excited because he had dropped his cigar on the ground without even noticing. “She spoke? Alicia really spoke?”

  “She did.”

  “Incredible. So you were right. You were right. And I was wrong.”

  “Not at all. It was wrong of me to see her without your permission, Professor. I’m sorry, I just had an instinct…”

  Diomedes waved away my apology and finished my sentence for me. “You followed your gut. I would have done the same, Theo. Well done.”

  I was unwilling to be too celebratory. “We mustn’t count our chickens yet. It’s a breakthrough, yes. But there’s no guarantee—she might revert or regress at any point.”

  Diomedes nodded. “Quite right. We must organize a formal review and interview Alicia as soon as possible—get her in front of a panel—you and me and someone from the Trust—Julian will do, he’s harmless enough—”

  “You’re going too fast. You’re not listening to me. That’s too soon. Anything like that will scare her. We need to move slowly.”

  “Well, it’s important the Trust knows—”

  “No, not yet. Maybe this was a one-off. Let’s wait. Let’s not make any announcements. Not just yet.”

  Diomedes nodded, taking this in. His hand reached for my shoulder and gripped it. “Well done. I’m proud of you.”

  I felt a small flicker of pride—a son congratulated by his father. I was conscious of my desire to please Diomedes, justify his faith in me and make him proud. I felt a little emotional. I lit a cigarette to disguise it. “What now?”

  “Now you keep going. Keep working with Alicia.”

  “And if Stephanie finds out?”

  “Forget Stephanie—leave her to me. You focus on Alicia.”

  And so I did.

  * * *

  During our next session, Alicia and I talked nonstop. Or rather, Alicia talked and I listened. Listening to Alicia was an unfamiliar and somewhat disconcerting experience, after so much silence. She spoke hesitantly at first, tentatively—trying to walk on legs that hadn’t been used in a while. She soon found her feet, picking up speed and agility, tripping through sentences as if she had never been silent, which in a way, she hadn’t.

  When the session ended, I went to my office. I sat at the desk, transcribing what had been said while it was still fresh in my mind. I wrote down everything, word for word, capturing it as precisely and accurately as possible.

  As you will see, it’s an incredible story—of that there is no doubt.

  Whether you believe it or not is up to you.

  CHAPTER ELEVEN

  ALICIA SAT IN THE CHAIR opposite me in the therapy room.

  “Before we begin, I have some questions for you. A few things I’d like to clarify…”

  No reply. Alicia looked at me with that unreadable look of hers.

  “Specifically, I want to understand your silence. I want to know why you refused to speak.”

  Alicia seemed disappointed by the question. She turned and looked out the window.

  We sat like that in silence for a minute or so. I tried to contain the suspense I was feeling. Had the breakthrough been temporary? Would we now go on as before? I couldn’t let that happen.

  “Alicia. I know it’s difficult. But once you start talking to me, you’ll find it easier, I promise.”

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nbsp; No response.

  “Try. Please. Don’t give up when you’ve made such progress. Keep going. Tell me … tell me why you wouldn’t speak.”

  Alicia turned back and stared at me with a chilly gaze. She spoke in a low voice:

  “Nothing … nothing to say.”

  “I’m not sure I believe that. I think there was too much too say.”

  A pause. A shrug. “Perhaps. Perhaps … you’re right.”

  “Go on.”

  She hesitated. “At first, when Gabriel … when he was dead—I couldn’t, I tried … but I couldn’t … talk. I opened my mouth—but no sound came out. Like in a dream … where you try to scream … but can’t.”

  “You were in a state of shock. But over the next few days, you must have found your voice returning to you…?”

  “By then … it seemed pointless. It was too late.”

  “Too late? To speak in your defense?”

  Alicia held me in her gaze, a cryptic smile on her lips. She didn’t speak.

  “Tell me why you started talking again.”

  “You know the answer.”

  “Do I?”

  “Because of you.”

  “Me?” I looked at her with surprise.

  “Because you came here.”

  “And that made a difference?”

  “All the difference—it made … all the difference.” Alicia lowered her voice and stared at me, unblinking. “I want you to understand—what happened to me. What it felt like. It’s important … you understand.”

  “I want to understand. That’s why you gave me the diary, isn’t it? Because you want me to understand. It seems to me the people who mattered most to you didn’t believe your story about the man. Perhaps you’re wondering … if I believe you.”

  “You believe me.” This was not a question but a simple statement of fact.

  I nodded. “Yes, I believe you. So why don’t we start there? The last diary entry you wrote described the man breaking into the house. What happened then?”

  “Nothing.”

  “Nothing?”

  She shook her head. “It wasn’t him.”

  “It wasn’t? Then who was it?”

  “It was Jean-Felix. He wanted—he had come to talk about the exhibition.”

  “Judging by your diary, it doesn’t seem you were in the right state of mind for visitors.”

  Alicia acknowledged this with a shrug.

  “Did he stay long?”

  “No. I asked him to leave. He didn’t want to—he was upset. He shouted at me a bit—but he went after a while.”

  “And then? What happened after Jean-Felix left?”

  Alicia shook her head. “I don’t want to talk about that.”

  “No?”

  “Not yet.”

  Alicia’s eyes looked into mine for a moment. Then they darted to the window, considering the darkening sky beyond the bars. Something in the way she was tilting her head was almost coquettish, and the beginning of a smile was forming at the corner of her mouth. She’s enjoying this, I thought. Having me in her power.

  “What do you want to talk about?” I asked.

  “I don’t know. Nothing. I just want to talk.”

  So we talked. We talked about Lydia and Paul, and about her mother, and the summer she died. We talked about Alicia’s childhood—and mine. I told her about my father, and growing up in that house; she seemed curious to know as much as possible about my past and what had shaped me and made me who I am.

  I remember thinking, There’s no going back now. We were crashing through every last boundary between therapist and patient. Soon it would be impossible to tell who was who.

  CHAPTER TWELVE

  THE NEXT MORNING, we met again. Alicia seemed different that day somehow—more reserved, more guarded. I think it’s because she was preparing herself to talk about the day of Gabriel’s death.

  She sat opposite me and, unusually for her, looked straight at me and maintained eye contact throughout. She started speaking without being prompted; slowly, thoughtfully, choosing each phrase with care, as if cautiously applying brushstrokes to a canvas.

  “I was alone that afternoon. I knew I had to paint, but it was so hot, I didn’t think I could face it. But I decided to try. So I took the little fan I’d bought down to the studio in the garden, and then…”

  “And then?”

  “My phone rang. It was Gabriel. He was calling to say he’d be back late from the shoot.”

  “Did he normally do that? Call to say he’d be late?”

  Alicia gave me an odd look, as if it struck her as a strange question. She shook her head. “No. Why?”

  “I wondered if he might be calling for another reason. To see how you were feeling? Judging from your diary, it sounds like he was concerned about your mental state.”

  “Oh.” Alicia pondered this, taken aback. She slowly nodded. “I see. Yes, yes, possibly…”

  “I’m sorry—I interrupted you. Go on. What happened after the phone call?”

  Alicia hesitated. “I saw him.”

  “Him?”

  “The man. I mean, I saw his reflection. Reflected in the window. He was inside—inside the studio. Standing right behind me.”

  Alicia shut her eyes and sat quite still. There was a long pause.

  I spoke gently. “Can you describe him? What did he look like?”

  She opened her eyes and stared at me for a moment. “He was tall.… Strong. I couldn’t see his face—he had put on a mask, a black mask. But I could see his eyes—they were dark holes. No light in them at all.”

  “What did you do when you saw him?”

  “Nothing. I was so scared. I kept looking at him. He had a knife in his hand. I asked what he wanted. He didn’t speak. And I said I had money in the kitchen, in my bag. And he shook his head and said, ‘I don’t want money.’ And he laughed. A horrible laugh, like breaking glass. He held the knife up to my neck. The sharp end of the blade was against my throat, against my skin.… He told me to go with him into the house.”

  Alicia shut her eyes as she remembered it. “He led me out of the studio, onto the lawn. We walked towards the house. I could see the gate to the street, just a few meters away—I was so close to it.… And something in me took over. It was—it was my only chance to escape. So I kicked him hard and broke away from him. And I ran. I ran for the gate.” Her eyes opened and she smiled at the memory. “For a few seconds, I was free.”

  Her smile faded.

  “Then—he jumped on me. On my back. We fell to the ground.… His hand was over my mouth, and I felt the cold blade against my throat. He said he’d kill me if I moved. We lay there for a few seconds, and I could feel his breath on my face. It stank. Then he pulled me up—and dragged me into the house.”

  “And then? What happened?”

  “He locked the door. And I was trapped.”

  Alicia’s breathing was heavy and her cheeks were flushed. I was concerned she was becoming distressed, and I was wary of pushing her too hard.

  “Do you need a break?”

  She shook her head. “Let’s keep going. I’ve waited long enough to say this. I want to get it over with.”

  “Are you sure? It might be a good idea to take a moment.”

  She hesitated. “Can I have a cigarette?”

  “A cigarette? I didn’t know you smoked.”

  “I don’t. I—I used to. Can you give me one?”

  “How do you know I smoke?”

  “I can smell it on you.”

  “Oh.” I smiled, feeling a little embarrassed. “Okay.” I stood up. “Let’s go outside.”

  CHAPTER THIRTEEN

  THE COURTYARD WAS POPULATED WITH PATIENTS. They were huddled about in their usual groups, gossiping, arguing, smoking; some were hugging themselves and stamping their feet to keep warm.

  Alicia put a cigarette to her lips, holding it between her long thin fingers. I lit it for her. As the flame caught the tip of her cigarette, it crackled and glowed red. She inhaled deeply, her eyes on mine. She seemed almost amused.

  “Aren’t you going to smoke? Or is that inappropriate? Sharing a cigarette with a patient?”

  She’s making fun of me, I thought. But she was right to—no regulation prohibited a member of staff and a patient from having a cigarette together. But if staff smoked, they tended to do it covertly, sneaking to the fire escape at the back of the building. They certainly didn’t do it in front of the patients. To stand here in the courtyard and smoke with her did feel like a transgression. I was probably imagining it, but I felt we were being watched. I sensed Christian spying on us from the window. His words came back to me: “Borderlines are so seductive.” I looked into Alicia’s eyes. They weren’t seductive; they weren’t even friendly. A fierce mind was behind those eyes, a sharp intelligence that was only just waking up. She was a force to be reckoned with, Alicia Berenson. I understood that now.

  Perhaps that’s why Christian had felt the need to sedate her. Was he scared of what she might do—what she might say? I felt a little scared of her myself; not scared, exactly—but alert, apprehensive. I knew I had to watch my step.

  “Why not?” I said. “I’ll have one too.”

  I put a cigarette in my mouth and lit it. We smoked in silence for a moment, maintaining eye contact, only inches from each other, until I felt a strange adolescent embarrassment and averted my gaze. I tried to cover it by gesturing at the courtyard.

  “Shall we walk and talk?”

  Alicia nodded. “Okay.”

  We started walking around the wall, along the perimeter of the courtyard. The other patients watched us. I wondered what they were thinking. Alicia didn’t seem to care. She didn’t even seem to notice them. We walked in silence for a moment.

  Eventually she said, “Do you want me to go on?”

  “If you want to, yes … Are you ready?”

  Alicia nodded. “Yes, I am.”

  “What happened once you were inside the house?”

  “The man said … he said he wanted a drink. So I gave him one of Gabriel’s beers. I don’t drink beer. I didn’t have anything else in the house.”

  “And then?”

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