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Chapter no 43

The Silent Patient

THE MEETING TOOK PLACE in Diomedes’s office, but Stephanie Clarke assumed control from the start. Now that we had left the abstract world of psychology and entered the concrete realm of health and safety, we were under her jurisdiction and she knew it. Judging by Diomedes’s sullen silence, it was obvious so did he.

Stephanie was standing with her arms crossed; her excitement was palpable. She’s getting off on this, I thought—being in charge, and having the last word. How she must have resented us all, overruling her, teaming up against her. Now she was relishing her revenge. “The incident yesterday morning was totally unacceptable,” she said. “I warned against Alicia being allowed to paint, but I was overruled. Individual privileges always stir up jealousies and resentments. I knew something like this would happen. From now on, safety must come first.”

“Is that why Alicia has been put in seclusion?” I said. “In the interest of safety?”

“She is a threat to herself, and others. She attacked Elif—she could have killed her.”

“She was provoked.”

Diomedes shook his head and spoke wearily. “I don’t think any level of provocation justifies that kind of attack.”

Stephanie nodded. “Precisely.”

“It was an isolated incident,” I said. “Putting Alicia in seclusion isn’t just cruel—it’s barbaric.” I had seen patients subjected to seclusion in Broadmoor, locked in a tiny, windowless room, barely enough space for a bed, let alone other furniture. Hours or days in seclusion was enough to drive anyone mad, let alone someone who was already unstable.

Stephanie shrugged. “As manager of the clinic, I have the authority to take any action I deem necessary. I asked Christian for his guidance, and he agreed with me.”

“I bet he did.”

Across the room, Christian smiled smugly at me. I could also feel Diomedes watching me. I knew what they were thinking—I was letting it get personal, and letting my feelings show; but I didn’t care.

“Locking her up is not the answer. We need to keep talking to her. We need to understand.”

“I understand perfectly,” Christian said with a heavy, patronizing tone, as if he were talking to a backward child. “It’s you, Theo.”

“Me?”

“Who else? You’re the one who’s been stirring things up.” “In what sense, stirring?”

“It’s true, isn’t it? You campaigned to lower her medication—”

I laughed. “It was hardly a campaign. It was an intervention. She was drugged up to the eyeballs. A zombie.”

“Bullshit.”

I turned to Diomedes. “You’re not seriously trying to pin this on me? Is that what’s happening here?”

Diomedes shook his head but evaded my eye. “Of course not. Nonetheless, it’s obvious that her therapy has destabilized her. It’s challenged her too much, too soon. I suspect that’s why this unfortunate event took place.”

“I don’t accept that.”

“You’re possibly too close to see it clearly.” Diomedes threw up his hands and sighed, a man defeated. “We can’t afford any more mistakes, not at such a critical juncture—as you know, the future of the unit is at stake. Every mistake we make gives the Trust another excuse to close us down.”

I felt intensely irritated at his defeatism, his weary acceptance. “The answer is not to drug her up and throw away the key. We’re not jailers.”

“I agree.” Indira gave me a supportive smile and went on, “The problem is we’ve become so risk averse, we’d rather overmedicate than take any

chances. We need to be brave enough to sit with the madness, to hold it— instead of trying to lock it up.”

Christian rolled his eyes and was about to object, but Diomedes spoke first, shaking his head. “It’s too late for that. This is my fault. Alicia isn’t a suitable candidate for psychotherapy. I should never have allowed it.”

Diomedes said he blamed himself, but I knew he was really blaming me. All eyes were on me: Diomedes’s disappointed frown; Christian’s gaze, mocking, triumphant; Stephanie’s hostile stare; Indira’s look of concern.

I tried not to sound as if I was pleading. “Stop Alicia painting if you must. But don’t stop her therapy—it’s the only way to reach her.”

Diomedes shook his head. “I’m beginning to suspect she’s unreachable.”

“Just give me some more time—”

“No.” The note of finality in Diomedes’s voice told me that arguing further was pointless. It was over.

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