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Chapter no 12

The Silent Patient

I WENT TO FIND DIOMEDESย to report on my meeting with Alicia. He was in his office, sorting through piles of sheet music.

โ€œWellโ€โ€”he didnโ€™t look upโ€”โ€œhow did it go?โ€ โ€œIt didnโ€™t, really.โ€

Diomedes gave me a quizzical glance.

I hesitated. โ€œIf Iโ€™m going to get anywhere with her, I need Alicia to be able to think, and feel.โ€

โ€œAbsolutely. And your concern isโ€ฆ?โ€

โ€œItโ€™s impossible to get through to someone when theyโ€™re so heavily medicated. Itโ€™s like sheโ€™s six feet underwater.โ€

Diomedes frowned. โ€œI wouldnโ€™t go that far. Iโ€™m not familiar with the exact dose sheโ€™s onโ€”โ€

โ€œI checked with Yuri. Sixteen milligrams of risperidone. A horseโ€™s dose.โ€

Diomedes raised an eyebrow. โ€œThatโ€™s certainly quite high, yes. It could probably be reduced. You know, Christian is the head of Aliciaโ€™s care team. You should talk to him about it.โ€

โ€œI think itโ€™ll sound better coming from you.โ€

โ€œHmm.โ€ Diomedes gave me a doubtful look. โ€œYou and Christian knew each other before, didnโ€™t you? At Broadmoor?โ€

โ€œVery slightly.โ€

Diomedes didnโ€™t respond immediately. He reached over to a little dish of sugared almonds on his desk and offered me one.

I shook my head.

He popped an almond in his mouth and crunched it, watching me as he chewed. โ€œTell me, is everything friendly between you and Christian?โ€

โ€œThatโ€™s an odd question. Why do you ask?โ€ โ€œBecause Iโ€™m picking up on some hostility.โ€ โ€œNot on my part.โ€

โ€œBut on his?โ€

โ€œYouโ€™ll have to ask him. I have no problem with Christian.โ€

โ€œHmm. Perhaps Iโ€™m imagining it. But Iโ€™m sensing something.โ€ฆ Keep an eye on it. Any aggression or competitiveness interferes with the work. You two need to work with each other, not against each other.โ€

โ€œIโ€™m aware of that.โ€

โ€œWell, Christian needs to be included in this discussion. You want Alicia to feel, yes. But remember, with greater feeling comes greater danger.โ€

โ€œDanger for whom?โ€

โ€œFor Alicia, of course.โ€ Diomedes wagged his finger at me. โ€œDonโ€™t forget she was highly suicidal when we first brought her here. She made numerous attempts to end her life. And the medication keeps her stable. It keeps her alive. If we lower the dose, thereโ€™s every chance she will be overwhelmed by her feelings and be unable to cope. Are you prepared to take that risk?โ€

I took what Diomedes said seriously. But I nodded. โ€œItโ€™s a risk I believe we need to take, Professor. Otherwise weโ€™ll never reach her.โ€

Diomedes shrugged. โ€œThen I shall talk to Christian on your behalf.โ€ โ€œThank you.โ€

โ€œWeโ€™ll see how he reacts. Psychiatrists donโ€™t often respond well to being told how to medicate their patients. Of course, I can overrule him, but I donโ€™t tend to do thatโ€”let me broach the subject with him subtly. Iโ€™ll tell you what he says.โ€

โ€œIt might be better not to mention me when you talk to him.โ€ โ€œI see.โ€ Diomedes smiled strangely. โ€œVery well, I wonโ€™t.โ€

He pulled out a little box from his desk, sliding off the cover to reveal a row of cigars. He offered me one. I shook my head.

โ€œYou donโ€™t smoke?โ€ He seemed surprised. โ€œYou look like a smoker to me.โ€

โ€œNo, no. Only the occasional cigaretteโ€”just now and then โ€ฆ Iโ€™m trying to quit.โ€

โ€œGood, good for you.โ€ He opened the window. โ€œYou know that joke, about why you canโ€™t be a therapist and smoke? Because it means youโ€™re still fucked-up.โ€ He laughed and popped one of the cigars into his mouth. โ€œI think weโ€™re all a bit crazy in this place. You know that sign they used to have in offices? โ€˜You donโ€™t need to be mad to work here, but it helpsโ€™?โ€

Diomedes laughed again. He lit the cigar and puffed on it, blowing the smoke outside. I watched him enviously.

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