Алекс Михаэлидес - The Silent Patient

I looked at my watch. “We have to finish now.”

Alicia lowered her head and stared at her lap. I hesitated. I lost control of my reserve. I lowered my voice and spoke from the heart.

“I want to help you, Alicia. I need you to believe that. The truth is, I want to help you to see clearly.”

At this, Alicia looked up. She stared at me—right through me.

You can’t help me, her eyes shouted. Look at you, you can barely help yourself. You pretend to know so much and be so wise, but you should be sitting here instead of me. Freak. Fraud. Liar. Liar—

As she stared at me, I became aware of what had been troubling me the whole session. It’s hard to put into words, but a psychotherapist quickly becomes attuned to recognizing mental distress, from physical behavior and speech and a glint in the eyes—something haunted, afraid, mad. And that’s what bothered me: despite the years of medication, despite everything she had done, and endured, Alicia’s blue eyes remained as clear and cloudless as a summer’s day. She wasn’t mad. So what was she? What was the expression in her eyes? What was the right word? It was—

Before I could finish the thought, Alicia leaped from the chair. She threw herself toward me, hands outstretched like claws. I had no time to move or get out the way. She landed on top of me, knocking me off-balance. We fell to the floor.

The back of my head hit the wall with a thud. She bashed my head against the wall again and again, and started scratching, slapping, clawing—it took all my strength to throw her off.

I scrambled along the floor and reached up to the table. I groped for the attack alarm. Just as my fingers grasped it, Alicia jumped on me and knocked the alarm from my hand.

“Alicia—”

Her fingers were tight around my neck, gripping, choking—I groped for the alarm but couldn’t reach it. Her hands dug deeper—I couldn’t breathe. I made another lunge—this time I managed to grab hold of the alarm. I pressed it.

A wailing scream instantly filled my ears, deafening me. I could hear the distant sound of a door opening and Yuri calling for backup. Alicia was dragged off me, releasing her choke hold—and I gasped for breath.

It took four nurses to hold Alicia down. She writhed and kicked and fought like a creature possessed. She didn’t seem human, more like a wild animal; something monstrous. Christian appeared and sedated her. She lost consciousness.

At last, there was silence.

CHAPTER FIVE

“THIS WILL STING A BIT.”

Yuri was tending to my bleeding scratches in the goldfish bowl. He opened the bottle of antiseptic and applied it to a swab. The medicinal odor transported me to the sick bay at school, conjuring up memories of playground battle scars, grazed knees and scratched elbows. I remembered the warm, cozy feeling of being taken care of by Matron, bandaged and rewarded for my bravery with a boiled sweet. Then the sting of the antiseptic on my skin brought me back sharply to the present, where the injuries I presented were not so easily remedied. I winced.

“My head feels like she hit me with a fucking hammer.”

“It’s a nasty bruise. You’ll have a lump tomorrow. We’d better keep an eye on it.” Yuri shook his head. “I never should have left you alone with her.”

“I didn’t give you a choice.”

He grunted. “That’s true enough.”

“Thanks for not saying, ‘I told you so.’ It’s noted and appreciated.”

Yuri shrugged. “I don’t need to, mate. The professor will say it for me. He’s asked to see you in his office.”

“Ah.”

“Rather you than me, by the look of him.”

I started getting up.

Yuri watched me carefully. “Don’t rush. Take a minute. Make sure you’re ready. Any dizziness or headaches, let me know.”

“I’m fine. Honestly.”

That wasn’t strictly true, but I didn’t feel as bad as I looked. Bloody scratches, and black bruises around my throat where she’d tried to strangle me—she’d dug so deep with her fingers, she’d drawn blood.

I knocked on the professor’s door. Diomedes’s eyes widened when he saw me. He tutted. “Po po po. Did you need stitches?”

“No, no, of course not. I’m fine.”

Diomedes gave me a disbelieving look and ushered me inside. “Come in, Theo. Sit down.”

The others were already there. Christian and Stephanie were standing. Indira was sitting by the window. It felt like a formal reception, and I wondered if I was about to get fired.

Diomedes sat behind his desk. He gestured to me to sit in the remaining empty chair. I sat. He stared at me in silence for a moment, drumming his fingers, deliberating what to say, or how to say it. But before he could make up his mind, he was beaten to it by Stephanie.

“This is an unfortunate incident. Extremely unfortunate.” She turned to me. “Obviously we’re all relieved you’re still in one piece. But that doesn’t alter the fact that it raises all kinds of questions. And the first is, what were you doing alone with Alicia?”

“It was my fault. I asked Yuri to leave. I take full responsibility.”

“On whose authority did you make that decision? If either of you had been seriously injured—”

Diomedes interrupted. “Please don’t let’s get dramatic. Thankfully neither was hurt.” He gestured at me dismissively. “A few scratches are hardly grounds for a court-martial.”

Stephanie pulled a face. “I don’t think jokes are really appropriate, Professor. I really don’t.”

“Who’s joking?” Diomedes turned to me. “I’m deadly serious. Tell us, Theo. What happened?”

I felt all their eyes on me; I addressed myself to Diomedes. I chose my words carefully. “Well, she attacked me. That’s what happened.”

“That much is obvious. But why? I take it was unprovoked?”

“Yes. At least, consciously.”

“And unconsciously?”

“Well, obviously Alicia was reacting to me on some level. I believe it shows us how much she wants to communicate.”

Christian laughed. “You call that communication?”

“Yes, I do. Rage is a powerful communication. The other patients—the zombies who just sit there, vacant, empty—they’ve given up. Alicia hasn’t. Her attack tells us something she can’t articulate directly—about her pain, her desperation, her anguish. She was telling me not to give up on her. Not yet.”

Christian rolled his eyes. “A less poetic interpretation might be that she was off her meds and out of her mind.” He turned to Diomedes. “I told you this would happen, Professor. I warned you about lowering the dose.”

“Really, Christian?” I said. “I thought it was your idea.”

Christian dismissed me with a roll of his eyes. He was a psychiatrist through and through, I thought. By that I mean psychiatrists tend to be wary of psychodynamic thinking. They favor a more biological, chemical, and, above all, practical approach—such as the cup of pills Alicia was handed at every meal. Christian’s unfriendly, narrow gaze told me that there was nothing I could contribute.

Diomedes, however, eyed me more thoughtfully. “It hasn’t put you off, Theo, what happened?”

I shook my head. “On the contrary, I’m encouraged.”

Diomedes nodded, looking pleased. “Good. I agree, such an intense reaction to you is certainly worth investigating. I think you should keep going.”

At this Stephanie could restrain herself no longer. “That’s absolutely out of the question.”

Diomedes kept talking as if she hadn’t spoken. He kept looking at me. “You think you can get her to talk?”

Before I could reply, a voice said from behind me, “I believe he can, yes.”

It was Indira. I’d almost forgotten she was there. I turned around.