Monday, May 20, 2024

Book Review: The Silent Patient by Alex Michaelides

Alicia Berenson, artist, lives in a gorgeous home in a desirable part of London with her husband who is a well-known fashion photographer. She has an upcoming art show, she is clearly very in love with her husband, and she appears to have everything. So why does she kill her husband? The Silent Patient is full of twists and turns. I suspected first one person then the next. 

Book cover of The Silent Patient

The Silent Patient is a psychological murder mystery that jumps from one point of view to another and includes Alicia's diary. The story isn't told in a linear timeline. The prologue is an excerpt from Alicia's Diary on July 14th soon before the murder in August. Chapter One begins with recap as though written by a report with the murder having happened six years prior. We learn about their careers, their art, their ages, and the last day of Gabriel's life. We learn the gory details of the murder scene, Alicia's attempt to take her own life and how she fought those trying to save her. We find that Alicia turned mute and remained silent. 

Alicia was discharged from the hospital and was initially under house arrest while waiting for the trial. She painted a self-portrait that she named Alcestis. 

Huge Cast of Characters:

Alcestis. A heroine of Greek mythology. Also, Alicia's self-portrait just after allegedly murdering her husband.

Alicia. A complicated, artistic woman, whose husband worried about her mood and well-being. He convinced her to start a diary. After all, maybe writing would help.

Jean-Felix Martin. The manager of a small SoHo Gallery who exhibited her art; including the Alcestis. Long lines formed outside of this small gallery to see what the murderer had painted. 

Lazarus Diomedes. The clinical director of the Grove, the secure forensic psychiatric unit in North London. Alicia was placed here due to clearly suffering from profound psychological distress as determined by the murder and the continuing refusal or inability to speak.  Diomedes oversaw her treatment at the Grove. Including the high level of sedating medications that both kept her safe for others and barely able to function.

Yuri. Head psychiatric nurse. Appears to do very well with managing the patients.

Christian. The head of Alicia's care team and the current prescriber of her medications. He clearly dislikes Theo from the moment we meet him. 

Theo Faber. Psychotherapist. Theo followed the trial closely and chose to interview at the Grove as a way to get close to Alicia. His goal is to treat her and to get her to talk. But Christian is the head of her care team.

The list of characters goes on and on. Max Berenson. Gabriel's brother and Alicia's attorney. What might he and other members of the Berenson family know? The patients in the unit, what might they know? Who has something to gain from her lengthy stay at the Grove and her silence? Why is the victim's brother also the attorney for the murderer? How do the gallery still show her art?  There are so very many questions.

Alicia has been violent on the unit. Which is why her medications are so high and sedating. It's not a far leap to assume that she committed the murder. But still... there are so many things that aren't right. 

My Thoughts

During each twist and turn, I kept thinking "that's not right". Both in the unit where Alicia is house and out of the unit. With every twist and turn I began to think someone else did it. I never did guess correctly. Did I miss the clues? 

Or... is it a matter of me missing the clues in this mystery? Or, to quote Annie Wilkes in Misery, "He never got out of the cockadoodie car" and the plot doesn't fully line up? It reminds me a bit of how I felt when I watched The Sixth Sense many, many years ago. Malcolm Crowe is a child psychologist and the child he's working with says, "I see dead people." I was stunned and thought, Whoa!  How'd we get here?!!!! I feel the same about The Silent Patient.

I can tell you that I've already started reading this a 2nd time to try to find what I missed and why I blamed the wrong people. How I missed seeing how we got to where we ended up. Or... was it a matter of plot problems. I don't know, but I'm reading it again.

The Silent Patient by Alex Michaelides can be found here on Amazon.

Currently, over 300,000 readers have reviewed this book on Amazon with a 4.4. out of 5 star rating. The negative reviews discuss the mental health issues, plot, and timeline issues. The vast majority of reviewers enjoyed this book. I found that the portrayal of the flawed mental health system and what can happen in those settings to be accurate. And the flawed mental health workers... same. I'm still not completely sure what I think of the plot/timeline. I can say that it was intriguing enough that I'm re-reading it already. 

Note: The author may receive a commission from purchases made using links found in this article. “As an Amazon Associate, Ebay (EPN) and/or Esty (Awin) Affiliate, I (we) earn from qualifying purchases.”


  1. What an intriguing book review. You have certainly drawn me into the story and you have me wondering what it is all about. I will have to seek out 'The Silent Patient' and discover for myself what you found. Thanks for the itnroduction, Dawn Rae.

  2. Although this genre isn’t my personal cup of tea, it definitely sounds intriguing and quite gripping. I can see why you want to re-read it! Thanks for the interesting review.

  3. My favorite kind of mystery is one full of twists and turns that keeps me guessing, and second guessing. This does sound like a book that would require your full attention when reading. Obviously, it would be easy to miss something important. I usually like the books and movies your recommend. I would love to know what you think after the second read, if you feel you missed something or if the book, itself, had plot issues.

  4. I love twists and turns but I'm not crazy, crazy for timelines that jump all over the place. The fact that you are re-reading makes me think I should take a look at this one though. Thanks Dawn Rae for your honest opinion on this book!!


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