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#TuesdayBookBlog THE SILENT PATIENT by Alex Michaelides (@NetGalley) An intriguing read, but not an accurate depiction of mental healthcare.

Hi, all:

Today I bring you a book that is proving very popular, although…

The Silent Patient by Alex Michaelides
The Silent Patient by Alex Michaelides

The Silent Patient by Alex Michaelides An intriguing read, but not an accurate depiction of mental healthcare.

Read the Sunday Times and No.1 New York Times bestselling, record-breaking 2019 thriller that everyone is talking about – soon to be a major film.

‘Terrific’ – THE TIMES Crime Book of the Month
‘Smart, sophisticated suspense’ – LEE CHILD
‘Absolutely brilliant’ – STEPHEN FRY
‘A totally original psychological mystery’ – DAVID BALDACCI
‘One of the best thrillers I’ve read this year’ – CARA HUNTER
‘The pace and finesse of a master’ – BBC CULTURE

Alicia Berenson writes a diary as a release, an outlet – and to prove to her beloved husband that everything is fine. She can’t bear the thought of worrying Gabriel, or causing him pain.

Until, late one evening, Alicia shoots Gabriel five times and then never speaks another word.

Forensic psychotherapist Theo Faber is convinced he can successfully treat Alicia, where all others have failed. Obsessed with investigating her crime, his discoveries suggest Alicia’s silence goes far deeper than he first thought.

And if she speaks, would he want to hear the truth?

THE SILENT PATIENT is the gripping must-read debut thriller of 2019 – perfect for fans of THE WOMAN IN THE WINDOW by A.J. Finn and THE GIRL BEFORE by JP Delaney.

Editorial Reviews Review

An Amazon Best Book of February 2019: The Silent Patient by Alex Michaelides feels like it could be the big psychological thriller debut of 2019. The novel takes a few chapters to clear its throat and set the plot in motion, but once the tracks are laid it’s full steam ahead. Alicia Berenson is one-half of a glamorous couple—she’s an artist married to her fashion photographer husband, Gabriel. But when Gabriel returns home late one night, she shoots him five times in the face and refuses to speak again. Now she is being held in an institution outside London called the Grove. When a psychotherapist named Theo Faber becomes obsessed with her case, he finds his way to the Grove to treat her. Dark twists and delightful turns follow, secrets (and a diary) are revealed, and you will likely find yourself racing to the end.–Chris Schluep, the Amazon Book Review

“Impressive first novel… with an ending worthy of a classic Agatha Christie mystery.”
The Wall Street Journal

“Superb… This edgy, intricately plotted psychological thriller establishes Michaelides as a major player in the field.”
Publisher’s Weekly, starred review

“Pulling off a novel where the protagonist stays mum isn’t easy, but this impressive, immersive debut―Brad Pitt’s company has snapped up film rights―establishes Michaelides as a writer to watch.”
People, Book of the Week

“Impressive debut…The Silent Patient is intelligent, imaginative and a terrific read.”
The Times (London), Book of the Month

The Silent Patient may be a first novel, but it has the pace and finesse of a master.”

“That rarest of beasts: the perfect thriller. This extraordinary novel set my blood fizzingI quite literally couldn’t put it down. I told myself I’d just dip in; eleven hours laterit’s now 5:47 a.m.I’ve finished it, absolutely dazzled.”
―A. J. Finn, #1 New York Times bestselling author of The Woman in the Window

The Silent Patient sneaks up on you like a slash of intimidating shadow on a badly lit street. Alex Michaelides has crafted a totally original, spellbinding psychological mystery so quirky, so unique that it should have its own genre. I read it in two nights and savored every luscious word, every grim encounter, every startling twist. The pages will burn with the friction from your hands turning them.”
―David Baldacci

“Smart, sophisticated storytelling freighted with real suspense―a very fine novel by any standard.”
―Lee Child

“One of the most spellbinding psychological thrillers we’ve read in years. Beautifully written, exquisitely plotted, the story relentlessly pulls you in and doesn’t let you go until the last shocking (and yet brutally logical) twist. This is an absolutely fantastic and extraordinary read.”
―Douglas Preston and Lincoln Child, #1 New York Times bestselling authors of the Pendergast series

“Alex Michaelides has written one of the best psychological thrillers I have ever read. The Silent Patient is a swarming, paranoid nightmare of a novel with an ending that is destined to go down as one of the most shocking, mind-blowing twists in recent memory.”
―Blake Crouch, New York Times bestselling author of Dark Matter

“This is a wonderful new voice. Listen to it. It’s about to tell you a thrilling and scary story. The Silent Patient paints a picture, crawling into your soul in the very best way. Take a chance.”
―Brad Meltzer, author of The Escape Artist

“Dark, edgy, and compulsively readable.”
Library Journal

The Silent Patient isn’t quiet at all. It loudly announces that Alex Michaelides is a new talent in the field of psychological thrillers.”
Shelf Awareness

“Unputdownable, emotionally chilling, and intense, with a twist that will make even the most seasoned suspense reader break out in a cold sweat.”

“A taut, meticulously plotted and compelling novel.”
The Observer

Author Alex Michaelides
Author Alex Michaelides

About the author:

Alex Michaelides was born in Cyprus to a Greek-Cypriot father and English mother. He has a MA in English Literature from Cambridge University and a MFA in Screenwriting from the American Film Institute in Los Angeles. The Silent Patient is his first novel.

My review:

Thanks to NetGalley and to Orion for providing me an ARC copy of this book that I freely chose to review.

Being a doctor (although I’d always had the same interest, even before studying Medicine), I’m always intrigued by books with the word “patient” (or doctor, hospital, or similar healthcare-related terms) in the title. Being a psychiatrist and having worked in forensic psychiatry in the UK, the description of this book seemed right up my alley. (And yes, in case you’re curious, I have treated patients who presented as temporarily mute, more than once, although not in circumstances quite as shocking as those in the book. Even one of the characters in one of my own thrillers is totally unresponsive after she is accused of a crime, but that’s another story). So I requested this book and it went into my very long list of books to read and review. Then, I started seeing great reviews, recommendations, etc., and grew curious, to the point where it jumped up to the top of my list.

Now, it’s quite difficult to review this book without revealing any spoilers, and this is a book where the twists in the plot are quite important, so I won’t be able to say much, as I’m sure many people will enjoy it and I don’t want to ruin it for them.

What can I tell you? What did I think? Well, I know this is a work of fiction, rather than a treatise in psychiatry or psychotherapy. (Theo Farber, one of the main characters, is a psychotherapist, a psychologist by training, not a medical doctor and, let’s say, he is not too enamoured with psychiatrists, anyway). But still, having work experience in high secure units in the UK, and also in low and medium secure units, both NHS and private, I couldn’t help but find so many things wrong with the characterisation of the professionals involved in the care of the other main character, Alice Berenson —the silent patient of the title— and also with the procedures followed and the way the unit is run, that it shattered my suspension of disbelief and made the rest of the book difficult to judge in its own right, for me. Despite the great reviews the book has had, I’ve noticed some other people have also had issues with the characterisation of the therapist and with other details of the novel, so if you are somebody who likes mysteries and thrillers to be realistic and tight when it comes to details, I’d say you should give it a miss.

The actual mystery side of the story… Well, as I said there are twists, more than one, red herrings, and some people have described it as original. Others, not so much. How well the twists work depends on how much you engage not only with the story, but also with the main characters. The story is narrated from two points-of-view, both in the first person, one the therapist’s, and one the patient’s, although, as must be evident from the title, the patient mostly does not talk, and what we get are entries from her diary, the diary she wrote before the events that landed her in the psychiatric unit. I like unreliable narrators, and they can work very well for mysteries, indeed. Here we have two. If Alice might be seen as an unreliable narrator due to her mental state, Theo seems to be very good at not applying his therapeutic insights (such as they are, but I’ve already said my piece on that and won’t insist) to himself and his own situation. But, I’m sure you won’t be surprised if I tell you that things are not quite as straightforward as they seem, even if you suspect they are far from straightforward.

My inkling is that people who don’t read tonnes of thrillers or mysteries are likely to enjoy this book more than people who mostly read thrillers and are used to smelling a rat from afar. Because of the issues I had with the novel, I included the editorial reviews, so you can get a sense of what the official line is on it. When I read the negative reviews I saw that some readers felt cheated by the twist (and yes, I understand that point of view, although,  as I said, I had other issues with the book); there were complaints about not liking any of the characters (other than the two main characters, none of the rest are drawn in much detail, I agree); some readers found the descriptions of therapies and the use of psychotherapeutic terms over the top (too much telling and not enough showing, and some complained they slowed the action); some reviewers objected to the use of swear-words (as this was mostly by one of the patients, from personal experience I’d say that bit is not unrealistic); and also some comments about a somewhat prejudiced depiction of a couple of characters (the Greek professor running the clinic comes out of it much better than the Turkish patient, it’s true). I mention those as a warning for people who are thinking about reading it and the concerns might resonate with them.

After reading the whole book, and with the caveats I’ve mentioned, personally, I was intrigued by the reference to a play by Euripides I hadn’t heard about, Alcestis, and I want to explore it further. I also enjoyed the references to Alice’s paintings and her creative process.

If you aren’t familiar with psychiatric care (particularly forensic psychiatric care in the UK), don’t regularly read tonnes of mysteries, and prefer books with enticing plots rather than those focused on a strong and psychologically consistent depiction of the characters, you are likely to enjoy this book. Otherwise, my recommendation would be to check a sample of the book and see if it hooks you and you feel compelled to keep reading.

Thanks to NetGalley and to the publisher, thanks to all of you for reading, and remember to like, share, comment, click, review, and always keep smiling.

By OlgaNunez

I was born in Barcelona and after living in the UK for many years have now returned home. I teach English, volunteer at Sants 3 Ràdio, a local radio station, I'm a writer, translator (English-Spanish and vice-versa) and I'm a medical doctor and worked in Forensic Psychiatry many years. I also have a BA and a PhD in American Literature and Film, and a Masters in Criminology. I've always loved books and apart from writing them I review them often.
I write a bit of everything, check my books for more information and my about page for links.
My blog is bilingual, English and Spanish.

27 replies on “#TuesdayBookBlog THE SILENT PATIENT by Alex Michaelides (@NetGalley) An intriguing read, but not an accurate depiction of mental healthcare.”

Hi Olga. This is where you shine, my friend. Thank you for this expert review. Whenever I read a book with such a specific “focus” (setting, whatever) I always wonder about the author’s expertise. Double that with something clinical. Regardless of storytelling talents, if that “focus” feels off to me, It gets in my way of enjoying the book.
Sure, being a great researcher is to an author’s benefit and it goes a long way. However, it doesn’t equal first hand knowledge. I like the old advice “Write what you know.”
Thank you for this exceptionally mindful review. Hugs on the wing!

Thanks so much, Teagan, and happy birthday! I’ve learned that sometimes the books that seem perfect for me, because they appeal to my interest and my experience, don’t live up to expectations, precisely because things that I might not notice in another book, really bother me (you’re not going to treat somebody who needs intensive care for medical reasons in a psychiatric hospital. Yes, we have what we call psychiatric intensive care units, but those are for the treatment of people severely disturbed, not suffering from a serious medical condition).
Have a fantastic week, Teagan.

Thanks, Rosie. Some of the things that bothered me won’t be that evident to most people, but some might. It is a page turner, for sure, but…
Have a great day.

Whenever I see a book getting so much ‘hype’, and an early film deal into the bargain, I always expect to be let down. Comparison with The Woman In The Window doesn’t help, as that didn’t work for me at all. I understand your own issues completely, as this would be much like me reading a novel set in the world of Paramedics. Hard not to keep thinking ‘that wouldn’t happen’, or ‘they wouldn’t say that’. I might wait until it gets heavily-discounted on Kindle, but I confess I am in no rush to read another ‘twisty’ thriller where I guess the twist too soon. 🙂
Best wishes, Pete.

Thanks, Pete. I am sure you would easily spot some of the gaffes yourself. I tend to avoid the hype as well, but as sometimes I get the books before their release, the word is not out yet. And there are a few that deserved the hype, but there are thrillers these days that tie themselves into knots trying to be original, and perhaps it’s not about that. Yes, The Woman in the Window definitely didn’t work for me (and since I’ve read quite a few things about the author that I’m not surprised about…). Have a great Tuesday!

I hope you enjoy it. Many people seem to love it. As long as you’re not a mental health professional, you’re probably not going to be bothered by the same issues I was. Have a great week!

Ummm, I know how you feel about the facts not stacking up, Olga. I feel the same way when I read books about corporate finance or the SEC that are untrue and, therefore, unbelievable. People should not write detail on a topic they don’t know well in my opinion.

Thanks, Robbie. I can imagine your frustration as well. You’d imagine that, especially with this being a book from a big publishing company, they’d check the facts or find an expert, although, to be honest, if the details were accurate, they would need to change the story quite a bit…
Have a great week!

Thanks, Rob. I know many readers wouldn’t be worried about the details, but I noticed some others were, and I thought it was worth mentioning. Thanks for your comment and for your fabulous artwork.

You’re welcome, Olga. There are too many negative stereotypes attached to mental illness and psychiatry and they prevent people from getting the help they need. Thank you for the kind comment on my artwork.

I absolutely agree with your review, Olga. I read it recently, as an audiobook, although I haven’t reviewed it yet. I enjoyed it, but I didn’t think it was an exceptional thriller, because, like you,, I also read many of them. Honest and useful review, by the way!

Thanks, Luccia. I read your reviews, and I know you are also a reader of the genre. I guess when one reads so many great reviews for a particular book, the expectations are increased. I look forward to checking your review as well. Enjoy the rest of the week.

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