Review: The Silent Patient by Alex Michaelides

“…We often mistake love for fireworks – for drama and dysfunction. But real love is very quiet, very still. It’s boring, if seen from the perspective of high drama. Love is deep and calm – and constant.”



Celadon Books | 2019

Filed Under: You know how you want to kill your spouse sometimes?

There was a lot of hype surrounding this book’s release, and for the most part, it was deserved. I mean, it didn’t totally blow my bits off and it didn’t necessarily reinvent the wheel when it comes to thrillers with unreliable narrators, but, for a debut novel it’s pretty impressive and I had a fun time reading it, so one eggplant up for Mr. Michaelides.

Alicia, an artist, killed her photographer husband. Shot him in the head repeatedly while he was tied to a chair, as a matter of fact. She’s been silent every day since. Locked up in a psych hospital, she hasn’t uttered a word in nearly seven years.

Theo Faber is a psychotherapist who is overly confident that he can crack Alicia’s proverbial silent nut. He takes a job in the hospital where she is remanded and starts his mostly one-sided conversations with Alicia in the hopes of getting her to finally explain why she did what she did to her husband, who by all accounts, she was madly in love with.

I don’t know about all of you, but while I jokingly say I’d like to murder the shit out of my husband sometimes, I don’t really mean it. Obviously, when he clips his toenails in bed and I say that I could really, truly smother him with a pillow until all the life drains from his body over it, I’m just speaking metaphorically.


This book is told from duelling POVs between Alicia’s diary entries and Theo’s present perspective. I was a little bit thrown by the fact that Theo is actually the main character of this story. I was expecting to be more involved in Alicia’s life and the mystery behind her husband’s murder. There were times following Theo around as he frets about his hot wife’s shitty affair, that I was a bit bored.

I wanted to be in the psych ward with the silent killer. That’s a weird statement to make, but it works in context.

What I didn’t want was to be lurking in the park as someone’s dumbass wife gets nailed in the bushes, no pun intended.

Of course, it all comes together in the end in a way that will shock some readers and have other readers tipping their hats to the author – save for the few that hated this book. I see y’all and respect your position on this.

Again I must say, (I have this complaint a lot it seems,) trying to make personal issues more interesting than a fucking murder doesn’t fly with me. Shot in the head > cheating spouse. Write accordingly.

While I get the whole thing with Theo and the twist and blah blah blah, the bulk of getting to that climax was uneven in terms of plotting. It pays off in the end, but literally at the very, very end.

For the rest of the book I was like, this guy is way too unhinged to be treating unhinged people and I don’t care about who his wife is banging.

I wanted more from Alicia. More diagnosis, more information, more background. More time in the psych hospital, as that is one of my all-time favourite settings. The plot possibilities are just so fucking endless in that locale. Maybe more time on Alicia would have helped this novel feel balanced and not so one-sided on the lame Doctor Faber with his creepy obsessions and daddy issues. He probably creases his jeans too. He just seems like the type.

lame episode 2 GIF

The plot, for the most part, is layered and gripping – though it could have been expanded on in some areas to make the mystery a little more engaging. The twist is quite clever, but not to toot my own boob, I did figure out what was coming. Because of this I was less “shocked” by the final pages and more impressed with the fact that this is a debut novel. It was a hell of a first effort.

I wouldn’t call this a “thriller” so much as it is suspense and flat-out trickery. But suspense and trickery done well.

Michaelides can really only get better from here (if he gets worse, don’t blame me.) So, if you feel like giving a debut author a chance, this is recommended!


Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word.

Alicia’s refusal to talk, or give any kind of explanation, turns a domestic tragedy into something far grander, a mystery that captures the public imagination and casts Alicia into notoriety. The price of her art skyrockets, and she, the silent patient, is hidden away from the tabloids and spotlight at the Grove, a secure forensic unit in North London.

Theo Faber is a criminal psychotherapist who has waited a long time for the opportunity to work with Alicia. His determination to get her to talk and unravel the mystery of why she shot her husband takes him down a twisting path into his own motivations—a search for the truth that threatens to consume him…. 

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