Алекс Михаэлидес - The Silent Patient

I hadn’t expected her to be in such bad shape. There were some echoes of the beautiful woman she had once been: deep blue eyes; a face of perfect symmetry. But she was too thin and looked unclean. Her long red hair was hanging in a dirty, tangled mess around her shoulders. Her fingernails were chewed and torn. Faded scars were visible on both her wrists—the same scars I’d seen faithfully rendered in the Alcestis portrait. Her fingers didn’t stop trembling, doubtless a side effect of the drug cocktail she was on—risperidone and other heavyweight antipsychotics. And glistening saliva was collecting around her open mouth, uncontrollable drooling being another unfortunate side effect of the medication.

I noticed Diomedes looking at me. I pulled my attention away from Alicia and focused on him.

“I’m sure you can introduce yourself better than I can, Theo,” he said. “Won’t you say a few words?”

“Thank you.” I nodded. “I don’t really have anything to add. Just that I’m very happy to be here. Excited, nervous, hopeful. And I’m looking forward to getting to know everyone—particularly the patients. I—”

I was interrupted by a sudden bang as the door was thrown open. At first I thought I was seeing things. A giant charged into the room, holding two jagged wooden spikes, which she raised high above her head and then threw at us like spears. One of the patients covered her eyes and screamed.

I half expected the spears to impale us, but they landed with some force on the floor in the middle of the circle. Then I saw they weren’t spears at all. It was a pool cue, snapped in two.

The massive patient, a dark-haired Turkish woman in her forties, shouted, “Pisses me off. Pool cue’s been broke a week and you still ain’t fucking replaced it.”

“Watch your language, Elif,” said Diomedes. “I’m not prepared to discuss the matter of the pool cue until we decide whether it’s appropriate to allow you to join Community at such a late juncture.” He turned his head slyly and threw the question at me. “What do you think, Theo?”

I blinked and took a second to find my voice. “I think it’s important to respect time boundaries and arrive on time for Community—”

“Like you did, you mean?” said a man across the circle.

I turned and saw it was Christian who had spoken. He laughed, amused by his own joke.

I forced a smile and turned back to Elif. “He’s quite right, I was also late this morning. So maybe it’s a lesson we can learn together.”

“What you on about?” Elif said. “Who the fuck are you anyway?”

“Elif. Mind your language,” said Diomedes. “Don’t make me put you on time-out. Sit down.”

Elif remained standing. “And what about the pool cue?”

The question was addressed to Diomedes—and he looked at me, waiting for me to answer it.

“Elif, I can see you’re angry about the pool cue,” I said. “I suspect whoever broke it was also angry. It raises the question of what we do with anger in an institution like this. How about we stick with that and talk about anger for a moment? Won’t you sit down?”

Elif rolled her eyes. But she sat down.

Indira nodded, looking pleased. We started talking about anger, Indira and I, trying to draw the patients into a discussion about their angry feelings. We worked well together, I thought. I could sense Diomedes watching, evaluating my performance. He seemed satisfied.

I glanced at Alicia. And to my surprise, she was looking at me—or at least in my direction. There was a dim fogginess in her expression—as if it was a struggle to focus her eyes and see.

If you told me this broken shell had once been the brilliant Alicia Berenson, described by those who knew her as dazzling, fascinating, full of life—I simply wouldn’t have believed you. I knew then and there I’d made the right decision in coming to the Grove. All my doubts vanished. I became resolved to stop at nothing until Alicia became my patient.

There was no time to waste: Alicia was lost. She was missing.

And I intended to find her.

CHAPTER SIX

PROFESSOR DIOMEDES’S OFFICE was in the oldest and most decrepit part of the hospital. There were cobwebs in the corners, and only a couple of the lights in the corridor were working. I knocked at the door, and after a moment’s pause I heard his voice from inside.

“Come in.”

I turned the handle and the door creaked open. I was immediately struck by the smell inside the room. It smelled different from the rest of the hospital. It didn’t smell like antiseptic or bleach; rather bizarrely, it smelled like an orchestra pit. It smelled of wood, strings and bows, polish, and wax. It took a moment for my eyes to become accustomed to the gloom, then I noticed the upright piano against the wall, an incongruous object in a hospital. Twenty-odd metallic music stands gleamed in the shadows, and a stack of sheet music was piled high on a table, an unsteady paper tower reaching for the sky. A violin was on another table, next to an oboe, and a flute. And beside it, a harp—a huge thing with a beautiful wooden frame and a shower of strings.

I stared at it all openmouthed.

Diomedes laughed. “You’re wondering about the instruments?” He sat behind his desk, chuckling.

“Are they yours?”

“They are. Music is my hobby. No, I lie—it is my passion.” He pointed his finger in the air dramatically. The professor had an animated way of speaking, employing a wide range of hand gestures to accompany and underscore his speech—as if he were conducting an invisible orchestra. “I run an informal musical group, open to whoever wishes to join—staff and patients alike. I find music to be a most effective therapeutic tool.” He paused to recite in a lilting, musical tone, “‘Music hath charms to soothe a savage breast.’ Do you agree?”

“I’m sure you’re right.”

“Hmm.” Diomedes peered at me for a moment. “Do you play?”

“Play what?”

“Anything. A triangle is a start.”

I shook my head. “I’m not very musical. I played the recorder a bit at school when I was young. That was about it.”

“Then you can read music? That is an advantage. Good. Choose any instrument. I will teach you.”

I smiled and again shook my head. “I’m afraid I’m not patient enough.”

“No? Well, patience is a virtue you would do well to cultivate as a psychotherapist. You know, in my youth, I was undecided whether I should be a musician, a priest, or a doctor.” Diomedes laughed. “And now I am all three.”

“I suppose that’s true.”

“You know”—he switched subjects without even a hint of a pause—“I was the deciding voice at your interview. The casting vote, so to speak. I spoke strongly in your favor. You know why? I’ll tell you—I saw something in you, Theo. You remind me of myself.… Who knows? In a few years, you might be running this place.” He left the sentence dangling for a moment, then sighed. “If it’s still here, of course.”

“You think it won’t be?”

“Who knows? Too few patients, too many staff. We are working in close cooperation with the Trust to see if a more ‘economically viable’ model can be found. Which means we are being endlessly watched, evaluated—spied upon. How can we possibly do therapeutic work under such conditions? you might well ask. As Winnicott said, you can’t practice therapy in a burning building.” Diomedes shook his head and looked his age suddenly—exhausted and weary. He lowered his voice and spoke in a conspiratorial whisper. “I believe the manager, Stephanie Clarke, is in league with them. The Trust pays her salary, after all. Watch her, and you’ll see what I mean.”

I thought Diomedes was sounding a little paranoid, but perhaps that was understandable. I didn’t want to say the wrong thing, so I remained diplomatically silent for a moment. And then—