The Silent Patient Read online

  Normally when beginning with a patient, there is no sense of urgency, no predetermined therapeutic agenda. Normally we start with many months of talking. In an ideal world, Alicia would tell me about herself, her life, her childhood. I would listen, slowly building up a picture until it was complete enough for me to make accurate, helpful interpretations. In this case, there would be no talking. No listening. The information I needed would have to be gathered through nonverbal clues, such as my countertransference—the feelings Alicia engendered in me during the sessions—and whatever information I could gather from other sources.

  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.

  CHAPTER EIGHT

  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.

  I wasn’t sure why this incident drew my attention. But it didn’t feel right to me. I decided to approach Elif and ask her about it.

  I tore off a sheet of paper from a pad and reached for my pen. An old habit, formed at university—something about putting pen to paper helps me organize my mind. I’ve always had difficulty formulating an opinion until I’ve written it down.

  I began scribbling ideas, notes, goals—devising a plan of attack. To help Alicia, I needed to understand her, and her relationship with Gabriel. Did she love him? Hate him? What happened to make her kill him? Why had she refused to speak about the murder—or anything else? No answers, not yet—just questions.

  I wrote down a word and underlined it: ALCESTIS.

  The self-portrait—it was important, somehow, I knew that, and understanding why would be central to unlocking this mystery. This painting was Alicia’s sole communication, her only testimony. It was saying something I had yet to comprehend. I made a note to revisit the gallery to look at the painting again.

  I wrote down another word: CHILDHOOD. If I was to make sense of Gabriel’s murder, I needed to understand not only the events of the night Alicia killed him, but also the events of the distant past. The seeds of what happened in those few minutes when she shot her husband were probably sown years earlier. Murderous rage, homicidal rage, is not born in the present. It originates in the land before memory, in the world of early childhood, with abuse and mistreatment, which builds up a charge over the years, until it explodes—often at the wrong target. I needed to find out how her childhood had shaped her, and if Alicia couldn’t or wouldn’t tell me, I had to find someone who would. Someone who knew Alicia before the murder, who could help me understand her history, who she was, and how she ended up this way.

  In the file, Alicia’s next of kin was listed as her aunt—Lydia Rose—who brought her up, following the death of Alicia’s mother in a car accident. Alicia had also been in the car crash, but survived. That trauma must have affected the little girl profoundly. I hoped Lydia would be able to tell me about it.

  The only other contact was Alicia’s lawyer: Max Berenson. Max was Gabriel Berenson’s brother. He was perfectly placed to observe their marriage intimately. Whether Max Berenson would confide in me was another matter. An unsolicited approach to Alicia’s family by her psychotherapist was unorthodox to say the least. I had a dim feeling Diomedes would not approve. Better not ask his permission, I decided, in case he refused.

  As I look back, this was my first professional transgression in dealing with Alicia—setting an unfortunate precedent for what followed. I should have stopped there. But even then it was too late to stop. In many ways my fate was already decided—like in a Greek tragedy.

  I reached for the phone. I called Max Berenson at his office, using the contact number listed in Alicia’s file. It rang several times before it was answered.

  “The offices of Elliot, Barrow, and Berenson,” said a receptionist with a bad cold.

  “Mr. Berenson, please.”

  “May I ask who is calling?”

  “My name is Theo Faber. I’m a psychotherapist at the Grove. I was wondering if it might be possible to have a word with Mr. Berenson about his sister-in-law.”

  There was a slight pause before she responded. “Oh. I see. Well, Mr. Berenson is out of the office for the rest of the week. He’s in Edinburgh visiting a client. If you leave your number, I’ll have him call you on his return.”

  I gave her my number and hung up.

  I dialed the next number in the file—Alicia’s aunt, Lydia Rose.

  It was answered on the first ring. An elderly woman’s voice sounded breathless and rather annoyed. “Yes? What is it?”

  “Is that Mrs. Rose?”

  “Who are you?”

  “I’m calling regarding your niece, Alicia Berenson. I’m a psychotherapist working at the—”

  “Fuck off.” She hung up.

  I frowned to myself.

  Not a good start.

  CHAPTER NINE

  I DESPERATELY NEEDED A CIGARETTE. As I left the Grove, I looked for them in my coat pockets, but they weren’t there.

  “Looking for something?”

  I turned around. Yuri was standing right behind me. I hadn’t heard him and I was a little startled to find him so close.

  “I found them in the nurses’ station.” He grinned, handing me my pack of cigarettes. “Must have fallen out of your pocket.”

  “Thanks.” I took them and lit one. I offered him the packet.

  Yuri shook his head. “I don’t smoke. Not cigarettes, anyway.” He laughed. “You look like you need a drink. Come on, I’ll buy you a pint.”

  I hesitated. My instinct was to refuse—I had never been one for socializing with work colleagues. And I doubted Yuri and I had much in common. But he probably knew Alicia better than anyone else at the Grove—and his insights might prove useful.

  “Sure,” I said. “Why not?”

  We went to a pub near the station, the Slaughtered Lamb. Dark and dingy, it had seen better days; so had the old men dozing over their half-finished pints. Yuri got us a couple of beers, and we sat at a table at the back.

  Yuri took a long swig of beer and wiped his mouth. “Well? Tell me about Alicia.”

  “Alicia?”

  “How did you find her?”

  “I’m not sure I did find her.”

  Yuri gave me a quizzical look, then smiled. “She doesn’t want to be found? Yeah, it’s true. She’s hiding.”

  “You’re close to her. I can see that.”

  “I take special care of her. No one knows her like I do, not even Professor Diomedes.”

  His voice had a boastful note. It annoyed me for some reason—I wondered how well he really knew her, or if he was just bragging.

  “What do you make of her silence? What do you think it means?”

  Yuri shrugged. “I guess it means she’s not ready to talk. She’ll talk when she’s ready.”

  “Ready for what?”

  “Ready for the truth, my friend.”

  “And what is that?”

  Yuri cocked his head to one side slightly, studying me. The question that came out of his mouth surprised me.

  “Are you married, Theo?”

  I nodded. “I am, yes.”

  “Yeah, I thought so. I was married once too. We moved here from Latvia. But she didn’t fit in like I did. She didn’t make an effort, you know, she didn’t learn English. Anyway, it wasn’t … I wasn’t happy—but I was in denial, lying to myself.…” He drained his drink and completed his sentence. “Until I fell in love.”

  “Presumably you don’t mean with your wife?”

  Yuri laughed and shook his head. “No. A woman who lived near me. A very beautiful woman. It was love at first sight. I saw her on the street. It took me a long time to get the courage to talk her. I used to follow her.… I’d watch her sometimes, without her knowing. I’d stand outside her house and look, hoping she would appear at the window.” He laughed.

  This story was starting to make me feel uncomfortable. I finished my beer and glanced at my watch, hoping Yuri would take the hint, but he didn’t.

  “One day I tried speaking to her. But she wasn’t interested in me. I tried a few times, but she told me to stop pestering her.”

  I didn’t blame her, I thought. I was about to make my excuses, but Yuri kept talking.

  “It was very hard to accept. I was sure we were meant to be together. She broke my heart. I got very angry with her. Very mad.”

  “And what happened?” I was curious despite myself.

  “Nothing.”

  “Nothing? You stayed with your wife?”

  Yuri shook his head. “No. It was over with her. But it took falling for this woman for me to admit it … to face the truth about me and my wife. Sometimes it takes courage, you know, and a long time, to be honest.”

  “I see. And you think Alicia’s not ready to face the truth about her marriage? Is that what you’re saying? You may well be right.”

  Yuri shrugged. “And now I’m engaged to a nice girl from Hungary. She works in a spa. She speaks good English. We’re a good match. We have a good time.”

  I nodded and checked my watch again. I picked up my coat. “I have to go. I’m late to meet my wife.”

  “Okay, no problem … What’s her name? Your wife?”

  For some reason, I didn’t want to tell him. I didn’t want Yuri to know anything about her. But that was stupid.

  “Kathryn. Her name is Kathryn. But I call her Kathy.”

  Yuri gave me an odd smile. “Let me give you some advice. Go home to your wife. Go home to Kathy, who loves you.… And leave Alicia behind.”

  CHAPTER TEN

  I WENT TO MEET KATHY at the National Theatre café on the South Bank, where the performers would often congregate after rehearsal. She was sitting at the back of the café with a couple of fellow actresses, deep in conversation. They looked up at me as I approached.

  “Are your ears burning, darling?” Kathy said as she kissed me.

  “Should they be?”

  “I’m telling the girls all about you.”

  “Ah. Should I leave?”

  “Don’t be silly. Sit down—it’s perfect timing. I’ve just got to how we met.”

  I sat down, and Kathy continued her story. It was a story she enjoyed telling. She occasionally glanced in my direction and smiled, as if to include me—but the gesture was perfunctory, for this was her tale, not mine.

  “I was sitting at a bar when he finally showed up. At last, when I’d given up hope of ever finding him—in he walked, the man of my dreams. Better late than never. I thought I was going to be married by the time I was twenty-five, you know? By thirty, I was going to have two kids, small dog, big mortgage. But here I was, thirty-three-ish, and things hadn’t quite gone to plan.” Kathy said this with an arch smile and winked at the girls.

  “Anyway I was seeing this Australian guy called Daniel. But he didn’t want to get married or have kids anytime soon, so I knew I was wasting my time. And we were out one night when suddenly it happened—Mr. Right walked in.” Kathy looked at me and smiled and rolled her eyes. “With his girlfriend.”

  This part of the story needed careful handling to retain her audience’s sympathy. Kathy and I were both dating other people when we met. Double infidelity isn’t the most attractive or auspicious start to a relationship, particularly as we were introduced to each other by our then partners. They knew each other for some reason, I can’t remember the precise details—Marianne had once gone out with Daniel’s flatmate possibly, or the other way around. I don’t remember exactly how we were introduced, but I do remember the first moment I saw Kathy. It was like an electric shock. I remember her long black hair, piercing green eyes, her mouth—she was beautiful, exquisite. An angel.

  At this point in telling the tale, Kathy paused and smiled and reached for my hand. “Remember, Theo? How we got talking? You said you were training to be a shrink. And I said I was nuts—so it was a match made in heaven.”

  This got a big laugh from the girls. Kathy laughed too and glanced at me sincerely, anxiously, her eyes searching mine. “No, but … darling … seriously, it was love at first sight. Wasn’t it?”

  This was my cue. I nodded and kissed her cheek. “Of course it was. True love.”

  This received a look of approval from her friends. But I wasn’t performing. She was right, it was love at first sight—well, lust anyway. Even though I was with Marianne that night, I couldn’t keep my eyes off Kathy. I watched her from a distance, talking animatedly to Daniel—and then I saw her lips mouth, Fuck you. They were arguing. It looked heated. Daniel turned and walked out.

  “You’re being quiet,” Marianne said. “What’s wrong?”

  “Nothing.”

  “Let’s go home, then. I’m tired.”

  “Not yet.” I was only half listening. “Let’s have another drink.”

  “I want to go now.”

  “Then go.”

  Marianne shot me a hurt look, then grabbed her jacket and walked out. I knew there’d be a row the next day, but I didn’t care.

  I made my way over to Kathy at the bar. “Is Daniel coming back?”

  “No. How about Marianne?”

  I shook my head. “No. Would you like another drink?”

  “Yes, I would.”

  So we ordered two more drinks. We stood at the bar, talking. We discussed my psychotherapy training, I remember. And Kathy told me about her stint at drama school—she didn’t stay long, as she signed up with an agent at the end of her first year and had been acting professionally ever since. I imagined, without knowing why, that she was probably rather a good actress.

  “Studying wasn’t for me,” she said. “I wanted to get out there and do it—you know?”

  “Do what? Act?”

  “No. Live.” Kathy tilted her head, looking out from under her dark lashes, her emerald-green eyes peering at me mischievously. “So, Theo. How do you have the patience to keep doing it—studying, I mean?”

  “Maybe I don’t want to get out there and ‘live.’ Maybe I’m a coward.”

  “No. If you were a coward, you’d have gone home with your girlfriend.” Kathy laughed, a surprisingly wicked laugh.

  I wanted to grab her and kiss her hard. I’d never experienced such overwhelming physical desire before; I wanted to pull her close, feel her lips and the heat of her body against mine.

  “I’m sorry,’ she said. ‘I shouldn’t have said that. I always say whatever pops into my head. I told you, I’m a bit nuts.”

  Kathy did that a lot, protesting her insanity—“I’m crazy,” “I’m nuts,” “I’m insane”—but I never believed her. She laughed too easily and too often for me to believe she’d ever suffered the kind of darkness I had experienced. She had a spontaneity, a lightness—she took a delight in living and was endlessly amused by life. Despite her protestations, she seemed the least crazy person I’d ever known. Around her, I felt more sane.

  Kathy was American. She was born and brought up on the Upper West Side of Manhattan. Her English mother gave Kathy dual citizenship, but Kathy didn’t seem even remotely English. She was determinedly, distinctly un-English—not just in the way she spoke, but in the way she saw the world and how she approached it. Such confidence, such exuberance. I’d never met anyone like her.

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