The Silent Patient

On writing his debut novel, author Michaelides, who is also a screenwriter, said, "I was feeling very disillusioned as a screenwriter. I kept seeing scripts being mangled in the production and this sense of frustration made me decide to sit down and finally write a novel."[4] He rewrote the draft around 50 times before finalizing it. The Athenian tragedy Alcestis, by Euripides, served as an inspiration for the plot, while its narrative structure was influenced by Agatha Christie's writing.[4] Michaelides decided to set his novel in a psychiatric unit as he had worked at a secure psychiatric facility for teenagers while he was a psychotherapy student.[5]

Alicia Berenson, a famous painter, is held guilty for the murder of her husband, photographer Gabriel Berenson. Due to a plea of diminished responsibility, she is admitted to a secure forensic unit called the Grove. Theo Faber, a forensic psychotherapist with a keen interest in the Berenson case, successfully applies for a position at the Grove. At his request, he is placed in charge of Alicia, who has not spoken since the day of the murder. Although she remains mute during their therapy sessions, Alicia gives Theo her diary. In it, she describes being watched in her home by a masked man in the weeks before the murder.

To learn more about Alicia, Theo contacts her cousin. He narrates an incident from their childhood that had happened shortly after her mother's suicide. Alicia's father, in deep mourning for his wife, wished out loud that Alicia were dead instead. Theo understands that this has had a deep impact on her psyche. He repeats the episode back to her, which induces her to speak. She tells him that the masked man entered her house and murdered Gabriel.

It is revealed that Theo was the masked man. He had broken into the Berenson house to confront Gabriel, who had been having an affair with Theo's wife. Holding them at gunpoint, Theo had given Gabriel the choice to save either himself or his wife, and he chooses the former. Theo left without shooting either of them, as he had only intended to expose Gabriel's selfishness. Gabriel's betrayal reminds Alicia of her father, and she killed him. On hearing the news, Theo planned to help Alicia recover from her trauma by being her therapist.

When Alicia tells Theo the false story of the masked man, he realizes that she recognizes him. He attempts to murder her through a drug overdose. Unbeknownst to Theo, Alicia records the events in her diary before losing consciousness, which is found by the police. They go to Theo's house and start reading him Alicia's final entry, while he feels a sense of relief at being caught.

The novel received generally positive reviews from critics. The Independent lauded the book for its plot, characters and style, writing: "[the book is] vivid enough to warrant devouring it in a day [...] the writing is scalpel-sharp and uncluttered, the style spare and concise, uncrowded with extraneous detail."[6] The Guardian concurred, praising its "tight, uncluttered prose" and "skillful building [of] tension until the novel’s shocking denouement". Deccan Herald called it "an intelligent plot coupled with an interesting character study, and finally the impactful punch that leaves you flabbergasted." The Washington Post praised the plot as "fresh" but criticised its "hacky horror tropes, trite scenes and comically shifty red herring characters."[7] Another negative review came from Kirkus Reviews, who panned the book as "clumsy, contrived, and silly [...] with a twist savvy readers will see coming from a mile away."[8]