Chapter no 12

The Silent Patient

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

“Well”—he didn’t look up—“how did it go?” “It didn’t, really.”

Diomedes gave me a quizzical glance.

I hesitated. “If I’m going to get anywhere with her, I need Alicia to be able to think, and feel.”

“Absolutely. And your concern is…?”

“It’s impossible to get through to someone when they’re so heavily medicated. It’s like she’s six feet underwater.”

Diomedes frowned. “I wouldn’t go that far. I’m not familiar with the exact dose she’s on—”

“I checked with Yuri. Sixteen milligrams of risperidone. A horse’s dose.”

Diomedes raised an eyebrow. “That’s certainly quite high, yes. It could probably be reduced. You know, Christian is the head of Alicia’s care team. You should talk to him about it.”

“I think it’ll sound better coming from you.”

“Hmm.” Diomedes gave me a doubtful look. “You and Christian knew each other before, didn’t you? At Broadmoor?”

“Very slightly.”

Diomedes didn’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. “Tell me, is everything friendly between you and Christian?”

“That’s an odd question. Why do you ask?” “Because I’m picking up on some hostility.” “Not on my part.”

“But on his?”

“You’ll have to ask him. I have no problem with Christian.”

“Hmm. Perhaps I’m imagining it. But I’m sensing something.… 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.”

“I’m aware of that.”

“Well, Christian needs to be included in this discussion. You want Alicia to feel, yes. But remember, with greater feeling comes greater danger.”

“Danger for whom?”

“For Alicia, of course.” Diomedes wagged his finger at me. “Don’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, there’s every chance she will be overwhelmed by her feelings and be unable to cope. Are you prepared to take that risk?”

I took what Diomedes said seriously. But I nodded. “It’s a risk I believe we need to take, Professor. Otherwise we’ll never reach her.”

Diomedes shrugged. “Then I shall talk to Christian on your behalf.” “Thank you.”

“We’ll see how he reacts. Psychiatrists don’t often respond well to being told how to medicate their patients. Of course, I can overrule him, but I don’t tend to do that—let me broach the subject with him subtly. I’ll tell you what he says.”

“It might be better not to mention me when you talk to him.” “I see.” Diomedes smiled strangely. “Very well, I won’t.”

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.

“You don’t smoke?” He seemed surprised. “You look like a smoker to me.”

“No, no. Only the occasional cigarette—just now and then … I’m trying to quit.”

“Good, good for you.” He opened the window. “You know that joke, about why you can’t be a therapist and smoke? Because it means you’re still fucked-up.” He laughed and popped one of the cigars into his mouth. “I think we’re all a bit crazy in this place. You know that sign they used to have in offices? ‘You don’t need to be mad to work here, but it helps’?”

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

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