The Silent Patient

The Silent Patient

by

Alex Michaelides

The Silent Patient: Part 5, Chapter 3 Summary & Analysis

Summary
Analysis
Julien McMahon, the head of the trust, sits Theo down and tells him that Diomedes has resigned. To Theo’s surprise, however, Julien has a job offer for him: the hospital is starting a new psychiatric center, and Theo seems like the perfect person to run it. Theo is elated by the prospect—now he will have a chance to help people just as Ruth helped him.
The fact that Theo will succeed professionally even as the Grove crumbles around him further demonstrates the self-involvement of his desire to treat the famous “silent patient.”
Themes
Empathy, Identification, and Boundaries Theme Icon
Theo explains that last year, he and Kathy moved to Surrey, back into his childhood home. They had wanted a garden and extra space, but almost 12 months later, they have yet to unpack their boxes or decorate. Instead, Kathy has started working less and eating more, watching TV all the time. A doctor suggested putting her on antidepressants, but Theo was opposed to it; Theo urged Kathy to go to talk therapy, but “Kathy doesn’t want to talk.”
As Michaelides himself notes, by the end of the novel, Alicia and Kathy have “swapped roles”: Alicia speaks, while Kathy—once known for her endless chatter—falls silent. In a classic example of a tragic twist, Theo has gone to near-murderous lengths to save his marriage with Kathy—but the marriage has collapsed anyway, as the two partners fall into their own private miseries.
Themes
Tragedy and Destiny Theme Icon
Silence vs. “The Talking Cure” Theme Icon
When Theo gets home, he tells her that a patient of his has overdosed—but even when he mentions the name Alicia Berenson, Kathy seems totally unfazed. Theo feels that they both “do a lot of pretending these days,” hiding their true circumstances and feelings from each other. He wants to confess to Ruth, but he feels that he is no longer able to talk to her: “I was altogether a different creature now, guiltier, less capable of honesty." He feels that he has failed not only Ruth but the entire practice of therapy, “the talking cure.”
At first, it seemed that Theo was honest while Kathy (and by extension Gabriel) were lying, “acting” out a part for their respective spouses. But by the end of the novel, everyone still alive is “pretending.” Without honesty, Theo seems to admit here, “the talking cure” means nothing; if one is not telling the truth, then therapy is really acting, playing a part rather than untangling a problem. 
Themes
Childhood Trauma Theme Icon
Silence vs. “The Talking Cure” Theme Icon
Quotes
The doorbell rings, and it is Chief Inspector Allen, who happens to be in the neighborhood. Kathy is confused, so Theo suggests she run upstairs and take her bath. While Theo makes Inspector Allen a cup of tea, the police officer discusses Jean-Felix Martin, who has recently dropped off all of Alicia’s paintings. Hidden in the back of the painting of the burning building, Inspector Allen reveals, was the diary. He pulls it out of his coat pocket, and Theo’s hands begin to tremble.
By hiding her diary in her painting—and by revealing the reality of Theo’s crimes in her diary—Alicia, “the silent patient,” proves herself to be a master communicator. And symbolically, Alicia’s decision to link her diary to her art shows that she is first and foremost a visual thinker, getting her message across not on Theo’s therapeutic terms but on her own artistic ones.
Themes
Empathy, Identification, and Boundaries Theme Icon
Silence vs. “The Talking Cure” Theme Icon
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Inspector Allen begins to read words Theo has never read before—the final entry in Alicia’s diary, from February 23rd. Theo realizes that the Inspector did not just happen to “be in the neighborhood.” Theo asks the Inspector to read the entire entry, and as he does, it begins to snow. Theo reaches his hand out to catch a snowflake. The first flake melts on his finger, and he goes “to catch another one.”
Now that Theo’s crimes are known, he will almost certainly face jailtime; his life will collapse completely. It is touching, then, that Theo spends this last second of freedom trying to catch snow, the very thing he associated in boyhood with happiness and escape. On the one hand, Theo’s desire for the snow reflects just how much his adult behavior has been shaped by his childhood pain. But more tragically, the melting snow signifies that despite his best efforts, Theo will never find real happiness; instead, he will always be trying, and failing, to “catch” it.
Themes
Tragedy and Destiny Theme Icon
Honesty vs. Deception Theme Icon
Quotes