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Chapter no 5

The Silent Patient

COMMUNITY WAS HELD IN A LONG ROOMย with tall barred windows that overlooked a redbrick wall. The smell of coffee was in the air, mingled with traces of Yuriโ€™s aftershave. About thirty people were sitting in a circle. Most were clutching paper cups of tea or coffee, yawning and doing their best to wake up. Some, having drunk their coffees, were fidgeting with the empty cups, crumpling, flattening them, or tearing them to shreds.

Community met once or twice daily; it was something between an administrative meeting and a group therapy session. Items relating to the running of the unit or the patientsโ€™ care were put on the agenda to be discussed. It was, Professor Diomedes was fond of saying, an attempt to involve the patients in their own treatment and encourage them to take responsibility for their well-being, although this attempt didnโ€™t always work. Diomedesโ€™s background in group therapy meant he had a fondness for meetings of all kinds, and he encouraged as much group work as possible. You might say he was happiest with an audience. He had the faint air of a theatrical impresario, I thought, as he rose to his feet to greet me, hands outstretched in welcome, and beckoned me over.

โ€œTheo. There you are. Join us, join us.โ€

He spoke with a slight Greek accent, barely detectableโ€”heโ€™d mostly lost it, having lived in England for over thirty years. He was handsome, and although in his sixties, he looked much youngerโ€”he had a youthful, mischievous manner, more like an irreverent uncle than a psychiatrist. This isnโ€™t to say he wasnโ€™t devoted to the patients in his careโ€”he arrived before the cleaners did in the morning and stayed long after the night team had taken over from the day staff, sometimes spending the night on the couch in

his office. Twice divorced, Diomedes was fond of saying his third and most successful marriage was to the Grove.

โ€œSit down here.โ€ He gestured to an empty chair by his side. โ€œSit, sit, sit.โ€

I did as he asked.

Diomedes presented me with a flourish. โ€œAllow me to introduce our new psychotherapist. Theo Faber. I hope you will join me in welcoming Theo to our little familyโ€”โ€

While Diomedes spoke, I glanced around the circle, looking for Alicia. But couldnโ€™t see her anywhere. Apart from Professor Diomedes, impeccably dressed in suit and tie, the others were mostly in short-sleeved shirts or T-shirts. It was hard to tell who was a patient and who was a member of staff.

A couple of faces were familiar to meโ€”Christian, for instance. I had known him at Broadmoor. A rugby-playing psychiatrist with a broken nose and a dark beard. Good-looking in a bashed-up kind of way. Heโ€™d left Broadmoor soon after I arrived. I didnโ€™t like Christian much, but to be fair I hadnโ€™t known him well, as we didnโ€™t work together for long.

I remembered Indira, from the interview. She smiled at me, and I was grateful, for hers was the only friendly face. The patients mostly glared at me with surly mistrust. I didnโ€™t blame them. The abuses they had sufferedโ€” physical, psychological, s*xualโ€”meant it would be a long time before they could trust me, if ever. The patients were all womenโ€”and most had course features, lined, scarred. Theyโ€™d had difficult lives, suffering from horrors that had driven them to retreat into the no-manโ€™s-land of mental illness; their journey was etched into their faces, impossible to miss.

But Alicia Berenson? Where was she? I looked around the circle again but still couldnโ€™t find her. Then I realizedโ€”I was looking right at her. Alicia was sitting directly opposite me, across the circle.

I hadnโ€™t seen her because she was invisible.

Alicia was slumped forward in the chair. She was obviously highly sedated. She was holding a paper cup, full of tea, and her trembling hand was spilling a steady stream of it onto the floor. I restrained myself from

going over and straightening her cup. She was so out of it I doubt sheโ€™d have noticed if I had.

I hadnโ€™t expected her to be in such bad shape. There were some echoes of the beautiful woman she had once been: deep blue eyes; a face of perfect symmetry. But she was too thin and looked unclean. Her long red hair was hanging in a dirty, tangled mess around her shoulders. Her fingernails were chewed and torn. Faded scars were visible on both her wristsโ€”the same scars Iโ€™d seen faithfully rendered in theย Alcestisย portrait. Her fingers didnโ€™t stop trembling, doubtless a side effect of the drug cocktail she was onโ€” risperidone and other heavyweight antipsychotics. And glistening saliva was collecting around her open mouth, uncontrollable drooling being another unfortunate side effect of the medication.

I noticed Diomedes looking at me. I pulled my attention away from Alicia and focused on him.

โ€œIโ€™m sure you can introduce yourself better than I can, Theo,โ€ he said. โ€œWonโ€™t you say a few words?โ€

โ€œThank you.โ€ I nodded. โ€œI donโ€™t really have anything to add. Just that Iโ€™m very happy to be here. Excited, nervous, hopeful. And Iโ€™m looking forward to getting to know everyoneโ€”particularly the patients. Iโ€”โ€

I was interrupted by a sudden bang as the door was thrown open. At first I thought I was seeing things. A giant charged into the room, holding two jagged wooden spikes, which she raised high above her head and then threw at us like spears. One of the patients covered her eyes and screamed.

I half expected the spears to impale us, but they landed with some force on the floor in the middle of the circle. Then I saw they werenโ€™t spears at all. It was a pool cue, snapped in two.

The massive patient, a dark-haired Turkish woman in her forties, shouted, โ€œPisses me off. Pool cueโ€™s been broke a week and you still ainโ€™t fucking replaced it.โ€

โ€œWatch your language, Elif,โ€ said Diomedes. โ€œIโ€™m not prepared to discuss the matter of the pool cue until we decide whether itโ€™s appropriate to allow you to join Community at such a late juncture.โ€ He turned his head slyly and threw the question at me. โ€œWhat do you think, Theo?โ€

I blinked and took a second to find my voice. โ€œI think itโ€™s important to respect time boundaries and arrive on time for Communityโ€”โ€

โ€œLike you did, you mean?โ€ said a man across the circle.

I turned and saw it was Christian who had spoken. He laughed, amused by his own joke.

I forced a smile and turned back to Elif. โ€œHeโ€™s quite right, I was also late this morning. So maybe itโ€™s a lesson we can learn together.โ€

โ€œWhat you on about?โ€ Elif said. โ€œWho the fuck are you anyway?โ€

โ€œElif. Mind your language,โ€ said Diomedes. โ€œDonโ€™t make me put you on time-out. Sit down.โ€

Elif remained standing. โ€œAnd what about the pool cue?โ€

The question was addressed to Diomedesโ€”and he looked at me, waiting for me to answer it.

โ€œElif, I can see youโ€™re angry about the pool cue,โ€ I said. โ€œI suspect whoever broke it was also angry. It raises the question of what we do with anger in an institution like this. How about we stick with that and talk about anger for a moment? Wonโ€™t you sit down?โ€

Elif rolled her eyes. But she sat down.

Indira nodded, looking pleased. We started talking about anger, Indira and I, trying to draw the patients into a discussion about their angry feelings. We worked well together, I thought. I could sense Diomedes watching, evaluating my performance. He seemed satisfied.

I glanced at Alicia. And to my surprise, she was looking at meโ€”or at least in my direction. There was a dim fogginess in her expressionโ€”as if it was a struggle to focus her eyes and see.

If you told me this broken shell had once been the brilliant Alicia Berenson, described by those who knew her as dazzling, fascinating, full of lifeโ€”I simply wouldnโ€™t have believed you. I knew then and there Iโ€™d made the right decision in coming to the Grove. All my doubts vanished. I became resolved to stop at nothing until Alicia became my patient.

There was no time to waste: Alicia was lost. She was missing. And I intended to find her.

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