The Silent Patient

“This is going to be a joyful record of ideas and images that inspire me artistically, things that make a creative impact on me. I’m only going to write positive, happy, normal, thoughts. No crazy thoughts allowed.” 

In the first pages of the novel, Alicia’s diary brings to light evident mental health issues. Her insistence that there are “no crazy thoughts allowed” suggests she struggles to keep her self-perceived insanity at bay. The epistolary technique allows the narrative to start with Alicia’s voice, acquainting the reader with her character despite her muteness. Alicia’s voice—through her diary—will also definitively conclude the narrative by implicating Theo. 

“I am not the hero of this tale. It is Alicia Berenson’s story, so I must begin with her—and the Alcestis.” 

At this point of the novel, Theo’s identity is not yet known. By taking the role of the nameless narrator, devoid of personal details, Theo focuses the narrative on Alicia’s story. This suggests that Alicia is the driving force of the narrative and, at first, this seems to be the case—after all, her murder of Gabriel drives the central plotline. However, Theo is the driver of this action, having been the direct cause of Alicia’s mental breakdown. Theo’s attempts to fade into the background in the first chapters thus appear disingenuous—as does his labeling Alicia a “hero” once Theo’s role of “rescuer” opposite her comes to light.