The Silent Patient by Alex Michaelides Book Review

Post edited by Admin.
Originally published on February 5, 2019
Genres: Thriller, Novel, Mystery, Psychological thriller, Suspense, Crime Fiction, Psychological Fiction

Scroll down for an alternative cover



Alecia has been in a mental hospital for years. Once, she was a popular painter in a happy marriage. Then one night, the cops find her surrounded by blood in her house with her husband tied and shot five times to the face. Her wrists were slit open, her fingerprints were on the gun. She didn’t defend herself. All she did was fight the police and the medics who tried to save her life. Ever since then, she hasn’t spoken a word. Instead, she painted one final piece and titled it Alcestes.

Theo is a psychotherapist. He is obsessed with Alecia’s case and when he finds an opening at the hospital she lives in, he takes it hoping he could be the one who would get her to speak.

As we follow Alecia’s journal and Theo’s attempts to study her, it is clear that there is much more to the story than what the rest of the world knows.

Non-Spoiler Review:


 Overall, I enjoyed it a lot. But still felt that a certain twist was added purely for shock value and that the book would hve been better without it.

The ending was great and satisfying and I did not guess the villain of the story at all. I enjoyed the snippets of Alecia’s diary a lot and I definitely liked trying to figure her out from Theo’s perspective too.

In the end, other than that twist (which is a personal preference since many love this title because of it) it was a very solid read for me.

Spoiler Review:


Okay, I’m just going to come out and say it: The “narrator is actually the bad guy” plot twist is one of my worst pet peeves in thrillers and mysteries.

The issue with this twist is the fact that it usually comes out of nowhere. It goes against everything we know about the character of the narrator and it feels like you’re suddenly reading from the POV of a completely different person.


But, I have to admit that with this book, the road was somewhat well paved for this reveal. The subtle hints that he is actually a very violent and disturbed individual that was reeling himself in, the way he stalked his wife earlier, it did not exactly come out of the blue.

And although I was pretty angry when I first read the part where he broke in, the chapter after that softened the blow. It answered most of my questions like “Why did he want to get her to talk? Why would he reveal his own murder attempt?” and though they weren’t perfect, they made sense, especially if you consider that he was after all mentally unhealthy, probably a narcissist, and at first driven by guilt, then self-preservation. He did get what he deserved by the end. I liked the last line of the book a lot. The callback to the first chapters was the perfect way to end this.

The reason I really enjoyed this book and was satisfied with the ending however, wasn’t this twist. It was what came after it. The fact that Alecia really did kill her husband. The way Gabriel’s murder was pretty much a modern retelling of Alcestis. The emotional journey that poor Alecia had gone through. From a mother that tried to kill her: to a father who wished her dead; to the abusive aunt. How when she finally met Gabriel and thought she got her happily ever after, he turned out to be a cheating coward. Here, her actions, though completely different and contrasting from her earlier journal entries, were completely logical. They were in character. They made sense.

This is why I came out of this book very satisfied.

Alternative cover 

I finished this book yesterday. And even now I am still thinking about that ending. I am still thinking about that tragedy and about Alecia and Theo.

Let us know in the comments if you have read this title, what your thoughts were and if you have not read it wether you will pick it up this year, then come back and share your thoughts about it.

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7 thoughts on “The Silent Patient by Alex Michaelides Book Review”

  1. I’ve read this title last year and since my memory is spotty when it runs at full capacity, I’m gonna try to go my best.
    I remember being cringed about some of the stuff going on and yet I remember liking it and being satisfied by the end of it. Must mean the author did something right, ha!
    If I recall (I went back and looked, hush) it was a 4 star-rating for me. I didn’t see it coming and I simply love when I can still be surprised with the amount of books I read.

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