An Enigmatic Mystery Drives ‘Silent Patient’

I’ve been reading a lot of tough stories lately: Lotus, Pachinko, Where the Crawdads Sing. Lots of women struggling against systemic sexism (and/or racism, classism, the works), lots of injustice. So when my digital library hold on The Silent Patient by Alex Michaelides came up, I wasn’t sure at all I was ready for a thriller’s take on femme fatales unjustly imprisoned.

Lucky for me, that’s not at all what The Silent Patient ended up being.

Alicia Berenson is found with her wrists slashed, a rifle at her feet, and her husband tied up in a chair with five bullets in what used to be his face. She is arrested, tried, convicted, and checked into a mental hospital. Through it all, she doesn’t utter a word. Six years later, Theo Faber, a psychotherapist, lands a job at her facility specifically to try to treat this enigmatic criminal. She still hasn’t spoken since the incident, despite the efforts of multiple therapists and doctors. Theo believes he can succeed where others have failed. What follows is a progressively alarming obsession that delves deep into her psyche and his.

Although Silent Patient is, on its face, a thriller about a woman going off the deep end, Theo presents a bit of an unreliable narrator himself, which is a bit refreshing after all the unreliable female narrators we’ve had lately with The Girl on the Train and the glut of like titles that have followed (I say as if I didn’t devour every one). Cut between his experiences at the hospital is his growing awareness that his wife is having an affair; between the two stressors, we see his decision-making capabilities spiral, and even when he admits he’s making bad choices, it’s hard not to cringe.

I don’t know if this will end up on my Top 10 list of books for the year but it did keep me turning pages. I found myself pulling out my phone and opening up my library app at every opportunity, including, I’ll admit a bit shamefully, during a break while hiking. The procedural quality of trying to determine Alicia’s motive for killing her husband feels a bit like the unraveling of His Bloody Project by Graeme Macrae Burnet. At turns, I was convinced of Alicia’s guilt, and then suspected one person after another from her old life.

There’s more I want to say about this—a lot more—but I’m actually going to restrain myself (unlike Theo) because the ending would be such a shame to spoil. The ending is on par with Mary Stewart’s The Ivy Tree or Lindsay Hunter’s Eat Only When You’re Hungry. I need to get someone I know to read this so I can talk about that ending.

Until then, I’ll stay silent.